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

Forms and Documents

Document Name	Status
CMS-R-262_CY2022_PBP_Sprtng_Stmnt.docx Supporting Statement A	2021-01-07
CY 2022 PBP List of Changes - 30day PRA.pdf Supplementary Document	2021-01-07
CY2022 PRA 60-day comments 1042021_response.docx Supplementary Document	2021-01-07

IC Document Collections

IC ID	Document Title	Status
43667	CY2022 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Instruction	Modified

ICR Details

OMB Control No: 0938-0763	ICR Reference No: 202101-0938-002
Status: Received in OIRA	Previous ICR Reference No: 202001-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/08/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2022
Responses	8,090	7,266
Time Burden (Hours)	74,038	67,368
Cost Burden (Dollars)	0	0

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Abstract: 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.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 101 Name of Law: Prescription Drug, Improvement, and Modernization Act of2003 (MMA)
  

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:
	85 FR 66990	10/21/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 99	01/04/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CY2022 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262)	CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262	#1a Inpatient Hospital-Acute – Base 1 ,   #19 VBID/MA Uniformity Flexibility/SSBCI ,   VBID – General ,   OON – General – Base 1 ,   MTMP CY2022 Mockups ,   Section A-1 ,   Plan Deductible LPPO/RPPO Base 1 ,   Medicare Rx General 1

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ICR Summary 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	8,090	7,266	0	0	824	0
Annual Time Burden (Hours)	74,038	67,368	0	0	6,670	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The increase to burden is attributable to an increase in the number of reporting organizations from 672 to 753, as well as an increase in the number of formulary submissions from 546 formularies submitted to 560. The number of reporting organizations increased from 672 contracts to 753 contracts based on the most recent numbers extracted from HPMS for organizations planning to provide Medicare to beneficiaries.

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Annual Cost to Federal Government: $1,665,394

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.     No

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.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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: 01/08/2021

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