Information Collection Request

Medicare Transaction Facilitator for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA) (CMS-10912)

ICR 202503-0938-001 · OMB unassigned · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10912 CMS-10912. 2025.05.08_MTF_ICR_Complaints&DisputesForm_clean Form and Instruction New Available
Form CMS-10912 Non-MTF User to Complete Drug Price Negotiation Program MTF DM Complaint Intake Form Form and Instruction New Repair queued
Form CMS-10912 CMS-10912. 2025.05.08_MTF_ICR_Complaints&DisputesForm_clean Form and Instruction New Available
Form CMS-10912 Primary Manufacturer and/or Dispensing Entity to Complete Drug Price Negotiation Program Complaint and Dispute Intake Form Form and Instruction New Repair queued
Form CMS-10912 CMS-10912.MTF_ICR_ManufacturerPaymentElementsForm_clean Form and Instruction New Repair queued
Form CMS-10912 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Payment Elements Form Form and Instruction New Repair queued
Form CMS-10912 CMS-10912.MTF_ICR_ MFPEffectuationPlanForm_clean Form and Instruction New Available
Form CMS-10912 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Primary Manufacturer MFP Effectuation Plan Form Form and Instruction New Repair queued
Form CMS-10912 CMS-10912.MTF_ICR_DispensingEntityEnrollmentForm_clean Form and Instruction New Available
Form CMS-10919 Dispensing Entity to Complete Drug Price Negotiation Program MTF DM Dispensing Entity and Third-Party Support Entity Enrollment Form Form and Instruction New Repair queued
CMS-10912.2025.05.08_MTF_ICR_Complaints&DisputesForm_redline.pdf Supplementary Document Uploaded 2025-05-09 Available
CMS-10912.MTF_ICR_DispensingEntityEnrollmentForm_redlined.pdf Supplementary Document Uploaded 2025-05-09 Repair queued
CMS-10912.MTF_ICR_ManufacturerPaymentElementsForm_redline.pdf Supplementary Document Uploaded 2025-05-09 Repair queued
CMS-10912.MTF_ICR_ MFPEffectuationPlanForm_redline.pdf Supplementary Document Uploaded 2025-05-09 Repair queued
CMS-10912. MTFICR_60_and_30-day_CommentResponseSummary_clean.docx Supplementary Document Uploaded 2025-05-09 Available
CMS-10912. 2025.05.08_IPAY 2026-27 30-day-to-Final_MTF ICR_Crosswalk.pdf Supplementary Document Uploaded 2025-05-09 Available
PFE_Second MTF ICR Comments_05012025.pdf Public Comments Uploaded 2025-05-01 Repair queued
PC_202503-0938-001_050125_055146_1.pdf Public Comments Uploaded 2025-05-01 Repair queued
2025-04-25 - CMS Letter - 340B MDN .pdf Public Comments Uploaded 2025-05-01 Repair queued
AZ_MTF ICR 30-day Comment Letter Final May 1, 2025.pdf Public Comments Uploaded 2025-05-01 Repair queued
CVS Health Response Medicare Transaction Facilitator for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA).pdf Public Comments Uploaded 2025-05-01 Repair queued
PC_202503-0938-001_050125_032139_1.pdf Public Comments Uploaded 2025-05-01 Repair queued
PhRMA -- Final Second Round MTF ICR Comment Letter (2025.05.01).pdf Public Comments Uploaded 2025-05-01 Available
PhRMA -- Final MTF ICR Comments (2024.12.20).pdf Public Comments Uploaded 2025-05-01 Repair queued
PC_202503-0938-001_050125_032700_1.pdf Public Comments Uploaded 2025-05-01 Repair queued
Second MTF ICR - Lilly Comment Letter.pdf Public Comments Uploaded 2025-05-01 Repair queued
PC_202503-0938-001_050125_024310_1.pdf Public Comments Uploaded 2025-05-01 Available
BMS Comments - MTF ICR Final_5.1.25.pdf Public Comments Uploaded 2025-05-01 Repair queued
PCMA Comments_ICR on MTF Proposed Forms for IPAY 2026 and 2027_CMS-10912_05012025.pdf Public Comments Uploaded 2025-05-01 Available
05 01 2025 NCPA Comments to CMS manu MFP effect plan FINAL.pdf Public Comments Uploaded 2025-05-01 Repair queued
05 01 2025 NCPA Comments to CMS MTF enrollment form FINAL.pdf Public Comments Uploaded 2025-05-01 Available
05 01 2025 NCPA Comments to CMS dispute intake form FINAL.pdf Public Comments Uploaded 2025-05-01 Available
PC_202503-0938-001_050125_111407_1.pdf Public Comments Uploaded 2025-05-01 Available
5_1_25_NACHC ICR on MFP and MTF_FINAL.pdf Public Comments Uploaded 2025-05-01 Available
PC_202503-0938-001_050125_094833_1.pdf Public Comments Uploaded 2025-05-01 Repair queued
NHIA MTF Information Collection letter_05012025 final.pdf Public Comments Uploaded 2025-05-01 Repair queued
PC_202503-0938-001_050125_093434_1.pdf Public Comments Uploaded 2025-05-01 Repair queued
BIO Comments MTF ICR Round 2 __Final.pdf Public Comments Uploaded 2025-04-30 Repair queued
PC_202503-0938-001_043025_032225_1.pdf Public Comments Uploaded 2025-04-30 Repair queued
JJ Comments - CMS Revised ICR - MTF Forms 4-30-25.pdf Public Comments Uploaded 2025-04-30 Repair queued
PC_202503-0938-001_043025_031608_1.pdf Public Comments Uploaded 2025-04-30 Repair queued
NACDS Comments CMS MFP ICR April 2024 FINAL.pdf Public Comments Uploaded 2025-04-30 Repair queued
PC_202503-0938-001_043025_093255_1.pdf Public Comments Uploaded 2025-04-30 Repair queued
PC_202503-0938-001_042925_104146_1.pdf Public Comments Uploaded 2025-04-29 Repair queued
PC_202503-0938-001_042725_080643_1.pdf Public Comments Uploaded 2025-04-27 Available
May 2025 - CMS MTF Comments on Letterhead - Final.pdf Public Comments Uploaded 2025-04-25 Available
PC_202503-0938-001_042525_032402_1.pdf Public Comments Uploaded 2025-04-25 Available
PC_202503-0938-001_040325_062405_1.pdf Public Comments Uploaded 2025-04-03 Repair queued
CMS-10912.2025.05.08_MTF ICR_SupportingStatementA_clean.docx Supporting Statement A Uploaded 2025-05-09 Available
CMS-10912.Supporting Statement Part A .docx Supporting Statement A Uploaded 2025-04-01 Repair queued
2025.03.10_IPAY 2026-27 60 to 30-day MTF ICR_Crosswalk_clean.docx Supplementary Document Uploaded 2025-03-20 Available
2025.03.10_IPAY 2026-27 60 to 30-day MTF ICR_Crosswalk_clean.docx Supplementary Document Uploaded 2025-03-20 Repair queued
60-Day Comments.pdf Public Comments Uploaded 2024-12-20 Repair queued
2025.03.10_MTFICR_CommentResponseSummary_clean.docx Supplementary Document Uploaded 2025-03-20 Available
2025.03.10_MTFICR_CommentResponseSummary_clean.docx Supplementary Document Uploaded 2025-03-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
274493 Non-MTF User to Complete Drug Price Negotiation Program MTF DM Complaint Intake Form Form and Instruction NewCMS-10912. 2025.05.08_MTF_ICR_Complaints&DisputesForm_clean
274493 Non-MTF User to Complete Drug Price Negotiation Program MTF DM Complaint Intake Form Form and Instruction New
274428 Primary Manufacturer and/or Dispensing Entity to Complete Drug Price Negotiation Program Complaint and Dispute Intake Form Form and Instruction NewCMS-10912. 2025.05.08_MTF_ICR_Complaints&DisputesForm_clean
274428 Primary Manufacturer and/or Dispensing Entity to Complete Drug Price Negotiation Program Complaint and Dispute Intake Form Form and Instruction New
274427 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Payment Elements Form Form and Instruction NewCMS-10912.MTF_ICR_ManufacturerPaymentElementsForm_clean
274427 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Payment Elements Form Form and Instruction New
274426 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Primary Manufacturer MFP Effectuation Plan Form Form and Instruction NewCMS-10912.MTF_ICR_ MFPEffectuationPlanForm_clean
274426 Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Primary Manufacturer MFP Effectuation Plan Form Form and Instruction New
274425 Dispensing Entity to Complete Drug Price Negotiation Program MTF DM Dispensing Entity and Third-Party Support Entity Enrollment Form Form and Instruction NewCMS-10912.MTF_ICR_DispensingEntityEnrollmentForm_clean
274425 Dispensing Entity to Complete Drug Price Negotiation Program MTF DM Dispensing Entity and Third-Party Support Entity Enrollment Form Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2027 36 Months From Approved
93,375 0 0
877,960 0 0
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Dispensing Entity to Complete Drug Price Negotiation Program MTF DM Dispensing Entity and Third-Party Support Entity Enrollment Form CMS-10912
Non-MTF User to Complete Drug Price Negotiation Program MTF DM Complaint Intake Form CMS-10912
Primary Manufacturer and/or Dispensing Entity to Complete Drug Price Negotiation Program Complaint and Dispute Intake Form CMS-10912
Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Payment Elements Form CMS-10912
Primary Manufacturer to Complete Drug Price Negotiation Program MTF DM Primary Manufacturer MFP Effectuation Plan Form CMS-10912

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 93,375 0 0 93,375 0 0
Annual Time Burden (Hours) 877,960 0 0 877,960 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No