Information Collection Request

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

ICR 202602-0938-002 · OMB 0938-0944 · Received in OIRA

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
[email protected] Public Comments Uploaded 2025-12-05 Available
Elevance Health Comments_BPT 2027 PRA_Final.pdf Public Comments Uploaded 2026-01-20 Available
CMS-10142_Attachment_B_Supporting_Statement.docx Supporting Statement A Uploaded 2026-02-03 Available
CMS-10142_Attachment_C_BPT_changes.pdf Supplementary Document Uploaded 2026-02-03 Available
CMS-10142_Response to Public Comments_60-day.pdf Supplementary Document Uploaded 2026-02-03 Available

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) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 03/31/2027
11,700 11,700
406,000 406,000
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 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 11,700 11,700 0 0 0 0
Annual Time Burden (Hours) 406,000 406,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No