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Annual State Report on CMS VBP Supplemental Rebate Agreements

IC 242409 under ICR 202405-0938-003 · OMB 0938-1385.

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Annual State Report on CMS VBP Supplemental Rebate Agreements
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10722 Annual State Report on CMS VBP Supplemental Rebate Agreements CMS-10722 - VBP State Data Worksheet (2024 version 1).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

51 0
   
State, Local, and Tribal Governments
 
   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 51 0 0 0 0 51
Annual IC Time Burden (Hours) 306 0 0 0 0 306
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
State Report - Crosswalk Crosswalk.pdf 05/03/2024
State Report - Redline REDLINE - CMS-10722 - VBP State Data Worksheet (2024 version 1).pdf 05/03/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.