The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-R-262_CY2023_PBP_Supporting Statement.docx	Supporting Statement A	Uploaded 2022-01-26	Repair queued
Appendix_B_CY 2023 PBP List of Changes - 30 Days PRA.pdf	Supplementary Document	Uploaded 2022-01-14	Repair queued
CY2023 PRA 60-day comments 1072022.docx	Supplementary Document	Uploaded 2022-01-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43667	CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262)	Instruction	Modified

ICR Details

OMB Control No: 0938-0763	ICR Reference No: 202201-0938-018
Status: Received in OIRA	Previous ICR Reference No: 202101-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/26/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2024
Responses	8,405	8,090
Time Burden (Hours)	76,378	74,038
Cost Burden (Dollars)	0	0

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Abstract: CMS requires that MA and PDP organizations submit a completed formulary and PBP as part of the annual bidding process. During this process, organizations prepare their proposed plan benefit packages for the upcoming contract year and submit them to CMS for review and approval.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 101 Name of Law: Prescription Drug, Improvement, and Modernization Act of2003 (MMA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 60245	11/01/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 4031	01/26/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262)	CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262	MTMP CY2022 Mockups ,   Section A-1 ,   #1a Inpatient Hospital-Acute – Base 1 ,   #19 VBID/MA Uniformity Flexibility/SSBCI ,   OON – General – Base 1 ,   Plan Deductible LPPO/RPPO Base 1 ,   Medicare Rx General 1 ,   VBID – General

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ICR Summary of 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	8,405	8,090	0	0	315	0
Annual Time Burden (Hours)	76,378	74,038	0	0	2,340	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The number of reporting organizations increasing from 753 contracts to 785 contracts is based on the most recent numbers extracted from HPMS for organizations planning to provide Medicare to beneficiaries. The decrease to burden is attributable to an increase in the number of reporting organizations from 753 to 785, as well as a decrease in the number of formulary submissions from 560 to 555.

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Annual Cost to Federal Government: $1,747,925

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/26/2022

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