Information Collection Request

Medication Therapy Management Program Improvements - Standardized Format (CMS-10396)

ICR 202104-0938-012 · OMB 0938-1154 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
60-day comment responses.pdf Supplementary Document Uploaded 2021-05-14 Missing upstream
CMS-10396 - Supporting Statement A (CMS-4190-F version 7).docx Supporting Statement A Uploaded 2021-05-14 Missing upstream
30-day crosswalk_508.pdf Supplementary Document Uploaded 2021-05-14 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
199672 Conducting CMRs with the standardized format and Fulfillment burden Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 02/29/2024
2,386,955 2,173,254
1,591,383 1,448,908
2,219,868 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Conducting CMRs with the standardized format and Fulfillment burden

table that charts list of burden
  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 2,386,955 2,173,254 0 213,701 0 0
Annual Time Burden (Hours) 1,591,383 1,448,908 0 142,475 0 0
Annual Cost Burden (Dollars) 2,219,868 0 0 2,219,868 0 0


Reginfo record details
  No