Information Collection Request
The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262) - IRA
ICR 202401-0938-014 · OMB 0938-0763 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0763 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-R-262 CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) |
Form and Instruction | Modified | Repair queued |
 Appendix_A_CMS-R-262_CY2025_PBP_Sprtng_Stmnt_.docx |
Supporting Statement A | Uploaded 2024-01-25 | Repair queued |
 Appendix_B_CY_2025 PBP List of Changes - 30 Days PRA.pdf |
Supplementary Document | Uploaded 2024-01-25 | Repair queued |
| CY2025 PRA 60-day comments 01082024_final.docx |
Supplementary Document | Uploaded 2024-01-25 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 43667 |  CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0763 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202302-0938-003 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |