Information Collection Request

Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

ICR 201603-0938-023 · OMB 0938-0578 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-367a, CMS-367b Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367) Form Modified Repair queued
OMB_RevisedPRA_Pkg_Disclosure_Screenshots.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-31 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8184 Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2019 03/31/2019 03/31/2019
12,810 0 12,810
3,612,603 0 3,612,603
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367) CMS-367a, CMS-367b, and CMS-367c Medicaid Drug Program Monthly and Quarterly Drug Reporting

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 12,810 12,810 0 0 0 0
Annual Time Burden (Hours) 3,612,603 3,612,603 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No