Medicare Part D Subsidies

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Addendum 0960-0702.docx	Supplementary Document	Uploaded 2026-08-27	Available
Supporting Statement - 0702 (final).docx	Supporting Statement A	Uploaded 2026-08-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9756	Medicare Part D Subsidy Rules - Section 20 CFR 418.3625(c)	Other-Regulation Section	Modified
185022	Medicare Part D Subsidy Rules - Section 20 CFR 418.3670	Other-Regulation Section	Modified
185021	Medicare Part D Subsidy Rules - Section 20 CFR 418.3665(a)	Other-Regulation Section	Modified
185020	Medicare Part D Subsidy Rules - Section 20 CFR 418.3645	Other-Regulation Section	Modified

ICR Details

OMB Control No: 0960-0702	ICR Reference No: 202607-0960-009
Status: Received in OIRA	Previous ICR Reference No: 202010-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Medicare Part D Subsidies
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/27/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	187	336
Time Burden (Hours)	16	29
Cost Burden (Dollars)	0	0

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Abstract: The Medicare Prescription Drug Improvement, and Modernization Act of 2003 (MMA) established the Medicare Part D program for voluntary prescription drug coverage of premium, deductible, and co-payment costs for certain low-income individuals. The MMA also mandated the provision of subsidies for those individuals who qualify for the program and who meet eligibility criteria for help with premium, deductible, or co-payment costs. This law requires SSA to make eligibility determinations and to provide a process for appealing SSA's determinations. Regulation sections 418.3625(c), 418.3645, 418.3665(a), and 418.3670 contain public reporting requirements pertaining to administrative review hearings. Respondents are applicants for the Medicare Part D subsidies who request an administrative review hearing.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 101 Name of Law: Medicare Modernization Act of 2003
  

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:
	91 FR 38753	06/26/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 55418	08/27/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Medicare Part D Subsidy Rules - Section 20 CFR 418.3625(c)
Medicare Part D Subsidy Rules - Section 20 CFR 418.3645
Medicare Part D Subsidy Rules - Section 20 CFR 418.3665(a)
Medicare Part D Subsidy Rules - Section 20 CFR 418.3670

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ICR Summary of Burden

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	187	336	0	0	-149	0
Annual Time Burden (Hours)	16	29	0	1	-14	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: When we cleared this ICR in 2023, the burden was 29 hours. However, we are currently reporting a burden of 16 hours. The decrease in burden is due to a decrease in the number of respondents requesting administrative review and may also be due to the impact of the Inflation Reduction Act (IRA) of 2022 which resulted in more individuals being eligible for full subsidy and consequently not opting to file appeals.

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Annual Cost to Federal Government: $40,552

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: 08/27/2026

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