Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)

OMB: 0938-0944

IC ID: 37926

Information Collection (IC) Details

View Information Collection (IC)

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) CM-CPC
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 422.316 42 CFR 422.318 42 CFR 422.320 42 CFR 422.322 42 CFR 423.258 42 CFR 422.314 42 CFR 423.265 42 CFR 423.272 42 CFR 423.251 42 CFR 422.254 42 CFR 422.250 42 CFR 422.270 42 CFR 423.336 42 CFR 423.315 42 CFR 423.343 42 CFR 422.300 42 CFR 422.312 42 CFR 423.308 42 CFR 422.308 42 CFR 423.350 42 CFR 422.304 42 CFR 422.324 42 CFR 423.346 42 CFR 423.329 42 CFR 423.322 42 CFR 422.266 42 CFR 423.279 42 CFR 423.286 42 CFR 423.293 42 CFR 422.264 42 CFR 422.252 42 CFR 422.256 42 CFR 422.258 42 CFR 422.262 42 CFR 422.306 42 CFR 423.301 42 CFR 422.310

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10142 Worksheets: Medicare Advantage Bid Pricing Tool CMS-10142_Attachment_D-1_CY2023_MA_BPT.pdf Yes Yes Fillable Printable
Form CMS-10142 Worksheets: Prescription Drug Bid Pricing Tool CMS-10142_Attachment_D-2_CY2023_PD_BPT.pdf Yes Yes Fillable Printable
Instruction CMS-10142_Attachment_E-1_CY2023_MA_BPT_Instructions.pdf Yes No Printable Only
Instruction CMS-10142_Attachment_E-2_CY2023_PD_BPT_Instructions.pdf Yes No Printable Only

Health Health Care Services

 

555 25
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,995 0 0 0 0 4,995
Annual IC Time Burden (Hours) 149,850 0 0 0 0 149,850
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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