Information Collection Request

Requirement for Electronic Prescribing for Controlled Substances (EPCS) for a Covered Part D Drug Under a Prescription Drug Plan or an MA–PD Plan (CMS-10834)

ICR 202512-0938-016 · OMB 0938-1455 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10834 EPCS Waiver Application Form and Instruction Modified Available
public comment.pdf Public Comments Uploaded 2025-10-30 Available
CMS-2025-0964-0003.html.pdf Public Comments Uploaded 2025-11-21 Available
Attachment A_CMS-10834 Response to 60 Day Public Comments_CLEANv1.0_508.pdf Supplementary Document Uploaded 2025-12-17 Available
CMS-10834 Supporting Statement A 12-15-25.docx Supporting Statement A Uploaded 2025-12-17 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
260452 Requirement for Electronic Prescribing for Controlled Substances (EPCS) for a Covered Part D Drug Under a Prescription Drug Plan or an MA–PD Plan Form and Instruction ModifiedEPCS Waiver Application

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
306 0
52 0
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Requirement for Electronic Prescribing for Controlled Substances (EPCS) for a Covered Part D Drug Under a Prescription Drug Plan or an MA–PD Plan CMS-10834

table that charts list 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 306 0 0 206 0 100
Annual Time Burden (Hours) 52 0 0 35 0 17
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No