The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262) - IRA

OMB 0938-0763

CMS requires that MA and PDP organizations submit a completed formulary and PBP as part of the annual bidding process. During this process, organizations prepare their proposed plan benefit packages for the upcoming contract year and submit them to CMS for review and approval.

The latest form for The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262) - IRA expires 2022-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-R-262 CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Form and Instruction
Appendix_A_CMS-R-262_CY2025_PBP_Sprtng_Stmnt_.docx Supporting Statement A
Appendix_B_CY_2025 PBP List of Changes - 30 Days PRA.pdf Supplementary Document
CY2025 PRA 60-day comments 01082024_final.docx Supplementary Document
CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Form and Instruction

All Historical Document Collections

202401-0938-014 Approved without change	Revision of a currently approved collection	2024-01-25
202302-0938-003 Approved with change	Revision of a currently approved collection	2023-02-08
202201-0938-018 Approved without change	Revision of a currently approved collection	2022-01-26
202101-0938-002	Revision of a currently approved collection	2021-01-08
202001-0938-005 Approved with change	Revision of a currently approved collection	2020-01-15
201904-0938-014 Comment filed on proposed rule and continue	Revision of a currently approved collection	2019-04-24
201901-0938-009 Approved with change	Revision of a currently approved collection	2019-02-13
201801-0938-001 Approved with change	Revision of a currently approved collection	2018-01-04
201701-0938-007 Approved with change	Revision of a currently approved collection	2017-02-17
201512-0938-009 Approved with change	Revision of a currently approved collection	2015-12-22
201412-0938-008 Approved without change	Revision of a currently approved collection	2014-12-19
201401-0938-012 Approved without change	Revision of a currently approved collection	2014-01-24
201301-0938-007 Approved without change	Revision of a currently approved collection	2013-01-22
201201-0938-004 Approved with change	Revision of a currently approved collection	2012-01-20
201102-0938-002 Approved with change	Revision of a currently approved collection	2011-02-01
201001-0938-002 Approved with change	Revision of a currently approved collection	2010-01-12
200901-0938-005 Approved with change	Revision of a currently approved collection	2009-01-23
200801-0938-003 Approved without change	Revision of a currently approved collection	2008-01-11
200709-0938-014 Approved without change	Revision of a currently approved collection	2007-09-30
200703-0938-005 Approved without change	Revision of a currently approved collection	2007-03-14
200607-0938-015 Approved with change	Extension without change of a currently approved collection	2006-07-13
200602-0938-001 Approved without change	Revision of a currently approved collection	2006-02-02
200509-0938-004 Approved with change	Extension without change of a currently approved collection	2005-09-06
200502-0938-011 Approved with change	Revision of a currently approved collection	2005-02-25
200303-0938-005 Approved without change	Revision of a currently approved collection	2003-03-18
200001-0938-006 Approved without change	Reinstatement with change of a previously approved collection	2000-01-13
199903-0938-007 Approved without change	New collection (Request for a new OMB Control Number)	1999-03-16