Information Collection Request
Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)
ICR 202304-0938-029 · OMB 0938-0578 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0578 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-376a DDR Quarterly Pricing Data (CMS-367a) |
Form | Modified | Repair queued |
| Form CMS-367e CMS-367e – Quarterly VBP-MBP Data |
Form | Unchanged | Repair queued |
| Form CMS-367d Supplemental Data Sheet (CMS-367d) |
Form | Modified | Repair queued |
 CMS-367a-e - Supporting Statement A (2023 version 5).docx |
Supporting Statement A | Uploaded 2023-05-03 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8184 |  DDR Quarterly Pricing Data (CMS-367a) |
Form | Modified | |
| 252237 | CMS-367e – System Updates |
Removed | ||
| 252230 | CMS-367e – Quarterly VBP-MBP Data |
Form | Unchanged | |
| 222507 | Supplemental Data Sheet (CMS-367d) |
Form | Modified | |
| 222506 | DDR Product Data (CMS-367c) |
Instruction | Modified | |
| 222505 | DDR Monthly Pricing Data (CMS-367b) |
Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0578 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202203-0938-002 |
| Agency Tracking No | CMCS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |