Medicaid Drug Rebate Program
- Manufacturers and Supporting Regulation at 42 CFR 447.534
(CMS-367)
Revision of a currently approved collection
No
Regular
02/26/2021
Requested
Previously Approved
36 Months From Approved
02/28/2023
14,980
14,117
558,980
536,670
0
0
Section 1927 of the Social Security
Act (the Act) requires drug labelers to enter into and have in
effect a rebate agreement with the Federal government for States to
receive funding for drugs dispensed to Medicaid recipients. In
order for payment to be made under Medicaid, the drug labeler must
complete and sign a drug rebate agreement and fill in the
information on the related documents. The drug manufacturer must
also supply information within 30 days after the end of each
calendar quarter and month on the average manufacturer price of the
drugs. Under the Medicaid program, states may provide coverage of
prescribed drugs as an optional service under section 1905(a)(12)
of the Social Security Act (the Act). Section 1903(a) of the Act
provides for federal financial participation (FFP) in state
expenditures for these drugs. Section 1927 of the Act governs the
Medicaid Drug Rebate (MDR) Program and payment for covered
outpatient drugs (CODs), which are defined in section 1927(k)(2) of
the Act. In general, for payment to be made available under section
1903(a) of the Act for CODs, manufacturers must enter into a
National rebate agreement (agreement) as set forth in section
1927(a) of the Act. Section 1927 of the Act provides specific
requirements for rebate agreements, drug pricing submission and
confidentiality requirements, the formulas for calculating rebate
payments, and requirements for states for CODs.
Statute at
Large: 19
Stat. 1927 Name of Statute: null
PL: Pub.L. 111 - 148 2503 Name of Law:
Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 226 202 Name of Law: Education Jobs and Medicaid
Assistance Act
In this 2020/2021 iteration we
have adjusted the number of respondents (manufacturer participation
increased from 743 to 749) and adjusted our labor rates to more
recent BLS data. The combination resulted in an increase in our
total time and total cost estimates. Our per response time
estimates are unchanged. Effective July 1, 2021, we are updating to
a new Medicaid Drug Programs (MDP) system which will now accept a
delimited text file format, Comma Separated Values (.CSV), in
addition to the current Text (.TXT) file format. We have also
increased several file format data field sizes in order to
accommodate the higher priced drugs that are entering the market.
These changes in conjunction with numerous edits to verbiage are
applicable to Forms CMS-304 and CMS-304a. This PRA package
(0938-0676) is simultaneously being updated along with our two
corresponding PRA packages (0938-0578 and 0938-0582), so that all
the MDP file formats, field sizes, and verbiage will align across
the MDRP. In this regard we added a one-time burden for each
manufacturer to make any system updates to accommodate the updated
field sizes and .CSV file formats for CMS-367a, CMS-367b, and
CMS-367c. See section 15 for more details regarding the
changes.
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.