Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)

ICR 201701-0938-005

OMB: 0938-0944

Federal Form Document

ICR Details
0938-0944 201701-0938-005
Historical Active 201512-0938-010
HHS/CMS CM-CPC
Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)
Revision of a currently approved collection   No
Regular
Approved with change 04/17/2017
Retrieve Notice of Action (NOA) 01/23/2017
  Inventory as of this Action Requested Previously Approved
04/30/2020 36 Months From Approved 04/30/2017
4,995 0 4,995
149,850 0 149,850
0 0 0

Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), and implementing regulations at 42 CFR, Medicare Advantage organizations (MAO) and Prescription Drug Plans (PDP) are required to submit an actuarial pricing "bid" for each plan offered to Medicare beneficiaries for approval by the Centers for Medicare & Medicaid Services (CMS). MAOs and PDPs use the Bid Pricing Tool (BPT) software to develop their actuarial pricing bid. The information provided in the BPT is the basis for the plan's enrollee premiums and CMS payments for each contract year.

US Code: 42 USC 1395w-24 Name of Law: SUBMISSION OF PROPOSED PREMIUMS, BID AMOUNTS, AND RELATED INFORMATION
  
None

Not associated with rulemaking

  81 FR 75406 10/31/2016
82 FR 6558 01/19/2017
No

1
IC Title Form No. Form Name
Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)-CMS-10142 CMS-10142, CMS-10142 Medicare Advantage: Worksheet 1 ,   Prescription Drug: Worksheet 1

  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 4,995 4,995 0 0 0 0
Annual Time Burden (Hours) 149,850 149,850 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$326,711
No
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/23/2017


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