CMS-367e – Quarterly VBP-MBP Data

Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

OMB: 0938-0578

IC ID: 252230

Information Collection (IC) Details

View Information Collection (IC)

CMS-367e – Quarterly VBP-MBP Data
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-367e Quarterly VBP-MBP Data CMS Form-367e MDP Online Data Entry Mockup_09.2021.pdf Yes Yes Fillable Fileable
Instruction CMS Form-367e_Quarterly VBP-MBP_09.2021_Final.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

50 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved 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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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