Information Collection Request

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)

ICR 202412-0938-016 · OMB 0938-0944 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10142 Worksheets: Prescription Drug Bid Pricing Tool Form Modified Available
Form CMS-10142 Worksheets: Medicare Advantage Bid Pricing Tool Form Modified Available
Form CMS-10142 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) Form Modified Repair queued
Comment on Federal_State Government Agency.pdf Public Comments Uploaded 2024-12-04 Repair queued
Comment from Public Health student.pdf Public Comments Uploaded 2024-12-05 Repair queued
UHC.pdf Public Comments Uploaded 2024-12-09 Repair queued
HealthHIV.pdf Public Comments Uploaded 2024-11-27 Repair queued
CMS-10142_Attachment_B_Supporting_Statement.docx Supporting Statement A Uploaded 2024-12-20 Repair queued
CMS-10142_Attachment_B_Supporting_Statement.docx Supporting Statement A Uploaded 2024-12-20 Repair queued
CMS-10142_Attachment_C_BPT_Changes.pdf Supplementary Document Uploaded 2024-12-20 Available
CMS-10142_Attachment_C_BPT_Changes.pdf Supplementary Document Uploaded 2024-12-20 Repair queued
PRA2026 CMS Response to Public Comments Received for CMS-10142.pdf Supplementary Document Uploaded 2024-12-20 Repair queued
PRA2026 CMS Response to Public Comments Received for CMS-10142.pdf Supplementary Document Uploaded 2024-12-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
37926 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) Form ModifiedWorksheets: Prescription Drug Bid Pricing Tool
37926 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) Form ModifiedWorksheets: Medicare Advantage Bid Pricing Tool
37926 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) Form Modified
37926 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2027 36 Months From Approved 03/31/2027
11,700 0 4,995
406,000 0 149,850
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) CMS-10142, CMS-10142 ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 11,700 4,995 0 0 6,705 0
Annual Time Burden (Hours) 406,000 149,850 0 0 256,150 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No