Retiree Drug Subsidy Payment Request Instructions (CMS-10170)

ICR 202008-0938-003

OMB: 0938-0977

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2020-08-14
Supplementary Document
2017-02-22
ICR Details
0938-0977 202008-0938-003
Received in OIRA 201702-0938-006
HHS/CMS CM-CPC
Retiree Drug Subsidy Payment Request Instructions (CMS-10170)
Reinstatement without change of a previously approved collection   No
Regular 08/17/2020
  Requested Previously Approved
36 Months From Approved
1,803 0
115,392 0
0 0

Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and implementing regulations at 42 CFR ?423 Subpart R, Plan Sponsors (e.g., employers or unions) that offer prescription drug coverage to their qualifying covered retirees are eligible to receive a 28% tax-free subsidy for allowable drug costs. In order to receive the subsidy, a Plan Sponsor must submit required prescription drug cost data and certain other data to CMS.

Statute at Large: 18 Stat. 1860 Name of Statute: null
   US Code: 42 USC 1395 W-132 Name of Law: Special Rules for employer sponsored programs
  
None

Not associated with rulemaking

  85 FR 34209 06/03/2020
85 FR 48255 08/10/2020
No

  Total Request 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 1,803 0 0 0 -679 2,482
Annual Time Burden (Hours) 115,392 0 0 0 -259,390 374,782
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The total burden is adjusted from 142,592 hr to 115,392 hr due to a reduction in RDS sponsor enrollment.

$10,100,000
No
    No
    No
No
No
No
No
Stephan McKenzie 410 786-1943 [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.
08/17/2020


© 2024 OMB.report | Privacy Policy