Pharmacy Billing Requirements

Forms and Documents

Document Name	Status
1240-0050 Pharmacy Billing Requirements 2025 7 28.docx Supporting Statement A	2025-07-28
Instructions for Required Data Elements for Pharmacy Bills.pdf Supplementary Document	2025-07-10
20 CFR 725.701 and 725.705 BLBA Supporting Reg.pdf Supplementary Document	2012-11-05
20 CFR 30.701 EEOICPA Supporting Reg.pdf Supplementary Document	2012-11-05
20 CFR 10.801 FECA Supporting Reg.pdf Supplementary Document	2012-11-05

IC Document Collections

IC ID	Document Title	Status
38474	Pharmacy Billing Requirements	Modified

ICR Details

OMB Control No: 1240-0050	ICR Reference No: 202506-1240-001
Status: Received in OIRA	Previous ICR Reference No: 202208-1240-004
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Pharmacy Billing Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/28/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2025
Responses	777,528	874,414
Time Burden (Hours)	12,994	14,481
Cost Burden (Dollars)	0	0

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Abstract: The National Council for Prescription Drug Programs standardized pharmacy billing data requirements are the electronic billing format used by pharmacies throughout the country to request payment for prescription drugs through data clearinghouses. They identify the provider, claimant, prescribing physician, drug by National Drug Code number, prescription volume and charge. Similar data elements are required to process paper-based pharmacy bills.

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Authorizing Statute(s): US Code: 30 USC 901 et seq Name of Law: Black Lung Benefits Act (BLBA)
   US Code: 42 USC 7384 et seq Name of Law: Energy Employees Occupational Illness Compensation Program Act
   US Code: 5 USC 8101 et seq Name of Law: Federal Employees' Compensation Act (FECA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 19731	05/09/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 35557	07/28/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Pharmacy Billing Requirements

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ICR Summary of Burden

	Total Request	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	777,528	874,414	0	0	-96,886	0
Annual Time Burden (Hours)	12,994	14,481	0	0	-1,487	0
Annual Cost Burden (Dollars)	0	0	0	-8,296,224	8,296,224	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: OWCP no longer accepts paper bills. All bills are submitted electronically. This reduced response time from 5 minutes to 1 minute on bills that were previously approved as manual bill submissions therefore reduced burden hours. Responses decreased from 874,414 to 777,528 due to less respondents (874,414 to 777,528). The decreases in responses as well as shortening response time due to electronic submissions also led to the corresponding decrease in total burden hours from 14,481 to 12,994. The previously submitted cost to respondents were none but erroneously recorded with a value. It is now corrected as no cost to respondents which matched the previous supporting statement.

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Annual Cost to Federal Government: $8,301,484

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/28/2025

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