Information Collection Request

[Medicaid] Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

ICR 202606-0938-019 · OMB 0938-0578 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-376a Quarterly Pricing Data Form Modified Available
Form CMS-367e Quarterly VBP-MBP Data Form Modified Available
Form CMS-367d Contact Information Sheet Form Modified Available
Form CMS-367c MDP Product Data Form and Instruction Modified Available
Form CMS-367b Monthly Pricing Data Form Modified Available
Cover Page - mlv-stfh-69c3.pdf Public Comments Uploaded 2026-02-20 Available
Comment - mlv-stfh-69c3.pdf Public Comments Uploaded 2026-02-20 Available
Cover Page - mlv-suft-s2li.pdf Public Comments Uploaded 2026-02-20 Available
Comment - mlv-suft-s2li.pdf Public Comments Uploaded 2026-02-20 Available
Cover Page - mlv-swy8-5qhd.pdf Public Comments Uploaded 2026-02-20 Available
Comment - mlv-swy8-5qhd.pdf Public Comments Uploaded 2026-02-20 Available
Cover Page - mlv-syq8-dvuk.pdf Public Comments Uploaded 2026-02-20 Available
Comment - mlv-syq8-dvuk.pdf Public Comments Uploaded 2026-02-20 Available
Cover Page - mlv-t0kc-9hj2.pdf Public Comments Uploaded 2026-02-20 Available
Comment - mlv-t0kc-9hj2.pdf Public Comments Uploaded 2026-02-20 Available
CMS-367a-e - Supporting Statement A (2026 version 4).docx Supporting Statement A Uploaded 2026-06-26 Available
Response to Public Comments (2026 version 2).docx Supplementary Document Uploaded 2026-06-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8184 DDR Quarterly Pricing Data (CMS-367a) Form ModifiedQuarterly Pricing Data
8184 DDR Quarterly Pricing Data (CMS-367a) Instruction Modified
252230 Quarterly VBP-MBP Data (CMS-367e) Form ModifiedQuarterly VBP-MBP Data
252230 Quarterly VBP-MBP Data (CMS-367e) Instruction Modified
222507 Supplemental Data Sheet (CMS-367d) Form ModifiedContact Information Sheet
222506 DDR Product Data (CMS-367c) Form and Instruction ModifiedMDP Product Data
222505 DDR Monthly Pricing Data (CMS-367b) Form ModifiedMonthly Pricing Data
222505 DDR Monthly Pricing Data (CMS-367b) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 07/31/2026
16,160 15,742
606,932 591,042
0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
DDR Monthly Pricing Data (CMS-367b) CMS-367b
DDR Product Data (CMS-367c) CMS-367c
DDR Quarterly Pricing Data (CMS-367a) CMS-376a
Quarterly VBP-MBP Data (CMS-367e) CMS-367e
Supplemental Data Sheet (CMS-367d) CMS-367d

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 16,160 15,742 0 418 0 0
Annual Time Burden (Hours) 606,932 591,042 0 15,890 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No