Pharmacy Billing Requirements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
1240-0050 Supporting Satement.doc	Supporting Statement A	Uploaded 2016-01-22	Available
DOL-ESA-49 (EEOICPA).pdf	Supplementary Document	Uploaded 2012-11-05	Available
DOL-ESA-6 (BLBA).pdf	Supplementary Document	Uploaded 2012-11-05	Available
DOL-GOVT-1 (FECA).pdf	Supplementary Document	Uploaded 2012-11-05	Available
20 CFR 725.701 and 725.705 BLBA Supporting Reg.pdf	Supplementary Document	Uploaded 2012-11-05	Available
20 CFR 30.701 EEOICPA Supporting Reg.pdf	Supplementary Document	Uploaded 2012-11-05	Available
20 CFR 10.801 FECA Supporting Reg.pdf	Supplementary Document	Uploaded 2012-11-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
38474	Pharmacy Billing Requirements	Instruction	Unchanged

ICR Details

OMB Control No: 1240-0050	ICR Reference No: 201601-1240-010
Status: Historical Active	Previous ICR Reference No: 201507-1240-006
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Pharmacy Billing Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/17/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/29/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	1,453,300	0	1,489,532
Time Burden (Hours)	24,421	0	26,917
Cost Burden (Dollars)	0	0	0

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Abstract: The NCPDP Standardized Pharmacy Billing Data Requirements are the electronic billing format used by pharmacies throughout the country to request payment for prescription drugs through data clearinghouses. They identify the provider, claimant, prescribing physician, drug by NDC (National Drug Code) number, prescription volume and charge. Similar data elements are required to process paper-based pharmacy bills.

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Authorizing Statute(s): US Code: 30 USC 901 et seq Name of Law: BLBA
   US Code: 42 USC 7384 et seq Name of Law: EEOICPA
   US Code: 5 USC 8101 et seq Name of Law: FECA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 50327	08/19/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 10666	03/01/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Pharmacy Billing Requirements

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ICR Summary of Burden

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	1,453,300	1,489,532	0	0	-36,232	0
Annual Time Burden (Hours)	24,421	26,917	0	0	-2,496	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There has been an increase in the number of electronic submission. As a result there is a decrease in burden hours from 26,917 to 24,421 which is an adjustment decrease of 2,496 burden hours.

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Annual Cost to Federal Government: $2,658,287

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/29/2016

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