4120-01-U-P
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10137, CMS-10170 and CMS-10156]
Agency Information Collection Activities: Proposed Collection; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Health and Human Services (HHS).
ACTION: Notice.
SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is announcing an
opportunity for the public to comment on CMS’ intention to collect information from the public.
Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish
notice in the Federal Register concerning each proposed collection of information (including
each proposed extension or reinstatement of an existing collection of information) and to allow
60 days for public comment on the proposed action. Interested persons are invited to send
comments regarding our burden estimates or any other aspect of this collection of information,
including the necessity and utility of the proposed information collection for the proper
performance of the agency’s functions, the accuracy of the estimated burden, ways to enhance
the quality, utility, and clarity of the information to be collected, and the use of automated
collection techniques or other forms of information technology to minimize the information
collection burden.
DATES: Comments must be received by [INSERT DATE 60 DAYS AFTER DATE OF
PUBLICATION IN THE FEDERAL REGISTER].
ADDRESSES: When commenting, please reference the document identifier or OMB control
number. To be assured consideration, comments and recommendations must be submitted in any
one of the following ways:

1. Electronically. You may send your comments electronically to
http://www.regulations.gov. Follow the instructions for "Comment or Submission" or "More
Search Options" to find the information collection document(s) that are accepting comments.
2. By regular mail. You may mail written comments to the following address:
CMS, Office of Strategic Operations and Regulatory Affairs
Division of Regulations Development
Attention: Document Identifier/OMB Control Number: 
Room C4-26-05
7500 Security Boulevard
Baltimore, Maryland 21244-1850.
To obtain copies of a supporting statement and any related forms for the proposed
collection(s) summarized in this notice, please access the CMS PRA web site by copying and
pasting the following web address into your web browser: https://www.cms.gov/Regulationsand-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing
FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the use and burden associated with the following
information collections. More detailed information can be found in each collection’s supporting
statement and associated materials (see ADDRESSES).
CMS-10137

Solicitation for Applications for Medicare Prescription Drug Plan 2026 Contracts

CMS-10170

Retiree Drug Subsidy Payment Request and Instructions

CMS-10156

Retiree Drug Subsidy (RDS) Application and Instructions

Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain approval from the
Office of Management and Budget (OMB) for each collection of information they conduct or
sponsor. The term "collection of information" is defined in 44 U.S.C. 3502(3) and 5 CFR

1320.3(c) and includes agency requests or requirements that members of the public submit
reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a 60-day notice in the Federal Register concerning each
proposed collection of information, including each proposed extension or reinstatement of an
existing collection of information, before submitting the collection to OMB for approval. To
comply with this requirement, CMS is publishing this notice.
Information Collections
1.

Type of Information Collection Request: Revision of a currently approved

collection; Title of Information Collection: Solicitation for Applications for Medicare
Prescription Drug Plan 2026 Contracts; Use: Coverage for the prescription drug benefit is
provided through contracted prescription drug plans (PDPs) or through Medicare Advantage
(MA) plans that offer integrated prescription drug and health care coverage (MA-PD plans). Cost
Plans that are regulated under Section 1876 of the Social Security Act, and Employer Group
Waiver Plans (EGWP) may also provide a Part D benefit. Organizations wishing to provide
services under the Prescription Drug Benefit Program must complete an application, negotiate
rates, and receive final approval from CMS. Existing Part D Sponsors may also expand their
contracted service area by completing the Service Area Expansion (SAE) application.
Collection of this information is mandated in Part D of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA) in Subpart 3. The application
requirements are codified in Subpart K of 42 CFR 423 entitled “Application Procedures and
Contracts with PDP Sponsors.”
The information will be collected under the solicitation of proposals from PDP, MA-PD,
Cost Plan, Program of All-Inclusive Care for the Elderly (PACE), and EGWP applicants. The
collected information will be used by CMS to: (1) ensure that applicants meet CMS requirements
for offering Part D plans (including network adequacy, contracting requirements, and
compliance program requirements, as described in the application), (2) support the determination

of contract awards. Form Number: CMS-10137 (OMB control number: 0938-0936); Frequency:
Yearly; Affected Public: Private Sector, Business or other for-profits and Not for profits
institution; Number of Respondents: 821; Number of Responses: 424; Total Annual Hours: 1,809.
(For policy questions regarding this collection contact April Forsythe at 410-786-8493.)
2.

Type of Information Collection Request: Revision of a currently approved

collection; Title of Information Collection: Retiree Drug Subsidy Payment Request and
Instructions; Use: Under the Medicare Prescription Drug, Improvement, and Modernization Act
of 2003 and implementing regulations at 42 CFR part 423 subpart R plan sponsors (e.g.,
employers, unions) who offer prescription drug coverage meeting specified criteria to their
qualified covered retirees are eligible to receive a 28% subsidy for allowable drug costs, through
the Retiree Drug Subsidy (RDS) Program. Section 423.886 describes the payment methods,
including the provision of necessary information. The information provided in the payment
request provides CMS with the information needed to pay RDS sponsors the subsidy.
The application process for the RDS is a completely electronic process (100%). The basis
for the decision for adopting this means of collection was to maximize efficiency. The only
instance when hard copy/paper applications can be submitted is when the RDS Center is
experiencing technical difficulties. The Plan Sponsor completes and submits the RDS application
(including the Plan Sponsor’s Authorized Representative’s electronic signature) on-line, via the
secure RDS Secure Web Site, which is accessed at https://www.rds.cms.hhs.gov. Form Number:
CMS-10170 (OMB control number: 0938-0977); Frequency: Yearly; Affected Public: Private;
Business or other for-profits, and Not-for Profits; Number of Respondents: 1,245; Number of
Responses: 1,245; Total Annual Hours: 187,995. (For questions regarding this collection, contact
Ivan Iveljic at 410-786-3312 or Ivan.iveljic@cms.hhs.gov.)
3.

Type of Information Collection Request: Revision of a currently approved

collection; Title of Information Collection: Retiree Drug Subsidy (RDS) Application and
Instructions ; Use: Under §1860D-22 of the Social Security Act (Act), added by the Medicare

Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and implementing
regulations at 42 CFR part 423 subpart R, Plan Sponsors (e.g., employers or unions) who offer
prescription drug coverage to their qualified covered retirees are eligible to receive a 28%
subsidy for allowable drug costs.
CMS has contracted with an outside vendor to assist in the administration of the RDS
program; this effort is called the RDS Center. Plan Sponsors will apply on-line for the retiree
drug subsidy by logging on to the RDS Secure Web Site. 42 CFR §423.844 describes the
requirement for qualified retiree prescription drug plans who want to receive the retiree drug
subsidy. Once the Plan Sponsor submits the RDS application via the RDS Secure Web Site (and
a valid initial retiree list) CMS, using its contractor, will analyze the application to determine
whether the Plan Sponsor qualifies for the RDS. To qualify for the subsidy, the Plan Sponsor
must show that its coverage is as generous as, or more generous than, the defined standard
coverage under the Medicare Part D prescription drug benefit. The information within the
application includes sponsor account registration information, plan information, benefit options
under the plan, actuary information and actuarial attestation. The RDS center has various checks
within each section of the application. Applications can be denied if issues cannot be resolved.
Form Number: CMS-10170 (OMB control number: 0938-0977); Frequency: Yearly; Affected
Public: Private Sector; Business or other for-profits, and Not-for Profits; Number of
Respondents: 1,245; Number of Responses: 1,245; Total Annual Hours: 79,680. (For questions
regarding this collection, contact Ivan Iveljic at 410-786-3312 or Ivan.iveljic@cms.hhs.gov.)
William N. Parham, III,
Director,
Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2024-14825 Filed: 7/5/2024 8:45 am; Publication Date: 7/8/2024]