Part C and Part D Medicare Prescription Payment Plan Model Documents (CMS-10882) - IRA

ICR 202507-0938-023

OMB: 0938-1475

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2025-07-28
Supplementary Document
2025-07-23
Supplementary Document
2025-07-23
IC Document Collections
IC ID
Document
Title
Status
267917 Modified
ICR Details
0938-1475 202507-0938-023
Received in OIRA 202409-0938-010
HHS/CMS CM-CPC
Part C and Part D Medicare Prescription Payment Plan Model Documents (CMS-10882) - IRA
Revision of a currently approved collection   No
Regular 07/29/2025
  Requested Previously Approved
36 Months From Approved 07/31/2025
39,514,987 1,065
135,080 21,300
43,841,218 8,686,462

The purpose of this information collection request for the approval of model documents for the Medicare Prescription Drug Program (Part D) is to meet the requirements of Section 11202 of the Inflation Reduction Act of 2022, Public L. 117-169 (IRA), which established the Medicare Prescription Payment Plan Program. Under this program, MA Organizations offering Part D coverage and Part D sponsors are required to offer enrollees the option to pay their Part D cost sharing in monthly amounts spread out over the plan year based on the formula described in section 1860D-2(b)(2)(E)(iv) of the Act. There are several education and outreach requirements for plan sponsors related to implementation of this program. The proposed documents in this information collection are designed to assist Part D plan sponsors and MA organizations in complying with Sections 1860D-2(b)(2)(E)(v)(II) – (IV) of the Social Security Act (the Act), which set forth the education and outreach responsibilities for Part D sponsors and MA organizations for this program. CMS has developed the six materials in the attached package as model notices to provide standardized and consistent language for potential and active program participants, regardless of which Part D plan they may be enrolled in. CMS will require Part D plans to disseminate these notices, as appropriate, to Part D enrollees to fulfill the requirements of the Sections 1860D-2(b)(2)(E)(v)(II) – (IV) of the Act. The six model notices and their related burden are accounted for in this PRA package. By providing these model notices, CMS is providing standardized messaging for all Part D beneficiaries and reducing administrative burden on Part D sponsors and MA organizations.

PL: Pub.L. 117 - 169 11202 Name of Law: Inflation Reduction Act of 2022
  
None

Not associated with rulemaking

  90 FR 20304 05/13/2025
90 FR 35529 07/28/2025
Yes

  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 39,514,987 1,065 0 39,513,922 0 0
Annual Time Burden (Hours) 135,080 21,300 0 113,780 0 0
Annual Cost Burden (Dollars) 43,841,218 8,686,462 0 35,154,756 0 0
Yes
Miscellaneous Actions
No
Burden has increased due to added burden and revised burden associated with the Medicare Prescription Payment Plan that was not accounted for in previous PRA packages, including annual burden for Part D plan sponsors to comply with requirements to mail billing statements, annual burden for Part D plan sponsors to report their program-specific PCN starting with “MPPP” to CMS, one-time burden for Part D plan sponsors to set up systems for participation renewal, one-time burden for Part D plan sponsors to develop the Notice of Participation Renewal, and annual burden for Part D plan sponsors to update their systems to reflect changes to the likely to benefit criteria. We also added one-time beneficiary burden to complete the opt-out process and annual burden for pharmacies to provide the Likely to Benefit Notice.

$2,826
No
    No
    No
No
No
No
No
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov

  No

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.
07/29/2025


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