MMA provides CMS the statutory
authority to require all Part D Sponsors (MA-PDs and PDPs) to
report data related to their operational costs and services. These
data will be analyzed for oversight and monitoring purposes, as
well as potentially initiating other groups within the agency to
perform functions such as fraud/waste/abuse investigations, audit
activities, and compliance. Title I, Part 423, ?423.514 describes
CMS' regulatory authority to establish reporting requirements for
Part D sponsors. It is noted that each Part D plan sponsor must
have an effective procedure to develop, compile, evaluate, and
report to CMS, to its enrollees, and to the general public, at the
times and in the manner that CMS requires, statistics in the
following areas: (1) The cost of its operations. (2) The patterns
of utilization of its services. (3) The availability,
accessibility, and acceptability of its services. (4) Information
demonstrating that the Part D plan sponsor has a fiscally sound
operation. (5) Other matters that CMS may require. Subsection
423.505 of the MMA regulation establishes as a contract provision
that Part D Sponsors must comply with the reporting requirements
for submitting drug claims and related information to CMS.
Statute at
Large: 1
Stat. 423 Name of Statute: null
For the CY2019 Reporting
Requirements, we removed the Retail, Home Infusion and Long-Term
Care Pharmacy Access section since the data are no longer necessary
for monitoring through these reporting requirements. There was an
overall increase in contract respondents (from 561 to 627) and plan
respondents (from 4,036 to 5,234) due to an increase in the total
number of Part D contracts. Overall, there was an increase in
responses (from 11,438 to 13,603) and total time (from 14,750 hr to
17,365 hr).
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.