Part D plans and, to the extent applicable, MA organizations will use the information discussed below to comply with the eligibility and other requirements associated with their participation in Part D. CMS will use this information from plan sponsors and States to approve contract applications, monitor compliance with contract requirements, make proper payment to plans, and ensure that correct information is disclosed to potential and current enrollees. The new information collection will allow CMS to ensure sponsors have plans in place to restore business operations following a disruption of regular operations. Medicare beneficiaries will use the information provided by the Part D sponsors to make decisions regarding Part D enrollment as well as grievance and appeal requests.
Under CMS-4182-P (RIN 0938-AT08), CMS will make the Preclusion List available to Part D sponsors. The Part D sponsors will perform system programming to maintain the Preclusion List in order to reject a pharmacy claim (or deny a beneficiary request for reimbursement) for a Part D drug that is prescribed by an individual on the Preclusion List.
CMS will create and disseminate model notices to the prescribers to notify them of their existence on the Preclusion List, while the Part D sponsors will create and disseminate model notices to the Medicare beneficiaries to notify them that the pharmacy claim is being rejected or denied due to the prescriber’s existence on the Preclusion List.
Statute at Large:
18 Stat. 1860
Name of Statute: null
PL:
Pub.L. 108 - 173 101
Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
PL: Pub.L. 108 - 173 101 Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
The currently approved ROCIS table (approved by OMB on 10/29/2015) incorrectly set out 7,588,143 hours of burden. This was mistakenly carried over from the initial 06/19/2015 Supporting Statement submission. The subsequent 10/27/2015 submission had set out 8,581,027 hours of burden which was in line with the section 12 burden summary table. That table, however, should have set out 8,581,800 hours (a difference of plus 773 hours). The 773 hour error was in the Medicare Prescription Drug Benefit Program (PLAN) burden which should have been 5,704,645 hours instead of 5,703,872 hours.
We are also adjusting our estimates by -18,128 hours, adding 1,402 hours based on the (CMS-4182-F) final rule's CARA provisions, and adding 102,121 hours based on the rule's Preclusion List provisions.
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:
(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;
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.
Form CMS-10141 Medicare Prescription Drug Benefit Program (Plans)
CMS-10141 - Supporting Statement A - 05-04-2018 CB - Passback2_cb2 CLEAN.docx
Crosswalk for Attachments 1 - 5.xlsx
Medicare Prescription Drug Benefit Program (Benes)