Medicaid Drug Rebate Program -- Manufacturers and supporting regulation at 42 CFR 447.534

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0578 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medicaid Drug Rebate Program -- Manufacturers and supporting regulation at 42 CFR 447.534	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CMS-367A	Yes	Yes
Form	CMS-367	Yes	Yes
Form	CMS-367C	Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 570	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 85 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,280	2,280
Annual IC Time Burden (Hours)	54,780	54,780
Annual IC Cost Burden (Dollars)	983,000	983,000

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.