Medicare Part D Reporting
Requirements and Supporting Regulations in MMA Title I, Part 423,
§423.514(a) (CMS-10185)
Revision of a currently approved collection
No
Regular
06/25/2021
Requested
Previously Approved
36 Months From Approved
12/31/2023
12,575
17,080
16,463
25,256
0
0
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.
Burden has decreased due to the
revision of several data elements in the Improving Drug Utilization
Review Controls section. These revisions include modifying existing
elements, adding new elements, and removing elements. The changes
improve the quality and reliability.
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.