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Solicitation for Applications for Medicare Prescription Drug Plan 2026 Contracts
Solicitation for Applications for Medicare Prescription Drug Plan 2026 Contracts (CMS-10137)
OMB: 0938-0936
IC ID: 43672
OMB.report
HHS/CMS
OMB 0938-0936
ICR 202410-0938-025
IC 43672
( )
Documents and Forms
Document Name
Document Type
Form CMS-10137
Solicitation for Applications for Medicare Prescription Drug Plan 2026 Contracts
Form and Instruction
CMS-10137 Solicitation for Application for Medicare Prescription D
2026 Part D Application PRA 30 Day CLEAN 508.docx
Form and Instruction
CMS-10137 PACE Medicare Part D Application
2025 PACE Part D Application 30 day CLEAN 508.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Solicitation for Applications for Medicare Prescription Drug Plan 2026 Contracts
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
42 CFR 423.120
42 CFR 423.440
42 CFR 423.153
42 CFR 423.512
42 CFR 423.514
42 CFR 423.112
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS-10137
Solicitation for Application for Medicare Prescription Drug Plan 2025 Contracts
2026 Part D Application PRA 30 Day CLEAN 508.docx
Yes
Yes
Fillable Printable
Form and Instruction
CMS-10137
PACE Medicare Part D Application
2025 PACE Part D Application 30 day CLEAN 508.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
821
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
424
0
0
-8
0
432
Annual IC Time Burden (Hours)
1,809
0
0
-31
0
1,840
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.