Information Collection Request

Solicitation for Applications for Medicare Prescription Drug Plan 2017 Contracts (CMS-10137)

ICR 201509-0938-014 · OMB 0938-0936 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10137 Solicitation for Applications for Medicare Prescription Drug Plan 2017 Contracts Form and Instruction Modified Available
PartD_supporting_statement - Passback _ Received 042916_CMSResponse [05-03-2016 CLEAN].docx Supporting Statement A Uploaded 2016-05-03 Available
Attachment 2 2017 Application Comment tracker 60 day_GB.xlsx Supplementary Document Uploaded 2015-09-30 Available
Response to 60 Day Comments.doc Supplementary Document Uploaded 2015-09-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
43672 Solicitation for Applications for Medicare Prescription Drug Plan 2017 Contracts Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2017 36 Months From Approved 11/30/2017
230 0 239
2,109 0 2,193
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Solicitation for Applications for Medicare Prescription Drug Plan 2017 Contracts CMS-10137, CMS-10137 Medicare Part D Application for New PACE Organizations 2016 Contract Year ,   Solicitation for Applications for Medicare Prescription Drug Plan 2017 Contracts

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 230 239 0 0 -9 0
Annual Time Burden (Hours) 2,109 2,193 0 0 -84 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No