CMS Notice on Plan Benefit Package and Formulary CY 2027 Information Collection

Content

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 a second opportunity for public comment on the notice. Interested persons are invited to send
comments regarding the burden estimate 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 on the collection(s) of information must be received by the OMB desk officer by April 24, 2026.

ADDRESSES:

Written comments and recommendations for the proposed information collection should be sent within 30 days of publication
of this notice to www.reginfo.gov/public/do/PRAMain. Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using
the search function.

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 website by copying and pasting the following web address into your web browser: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.

FOR FURTHER INFORMATION CONTACT:

William Parham at (410) 786-4669.

SUPPLEMENTARY INFORMATION:

Under the Paperwork Reduction Act of 1995 (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 (44 U.S.C. 3506(c)(2)(A))
requires federal agencies to publish a 30-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 that summarizes the following proposed collection(s) of information for public comment.

1. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: CMS Plan Benefit Package (PBP) and Formulary CY 2027; Use: Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), and implementing regulations at 42 CFR, specifically § 422.254 and § 423.265, Medicare Advantage (MA) and Prescription Drug Plan (PDP) organizations are required to submit a bid for each plan they intend to offer in their service area for the upcoming year. In addition to actuarial pricing, which is addressed in OMB 0938-0944, each bid submission consists of a description of the plan benefit package and the plan formulary. MA and PDP organizations use the Plan Benefit Package (PBP) software to describe their organization's plan benefit packages, including information on premiums, cost sharing, authorization rules, and supplemental benefits. They also generate a formulary to describe their list of drugs, including information on prior authorization, step therapy, tiering, and quantity limits. CMS uses the PBP and formulary data to review and approve the plan benefit packages proposed by each MA and PDP organization.

CMS requires that MA and PDP organizations submit a completed PBP and formulary 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. CMS uses this data to review and approve the benefit packages that the plans will offer to Medicare
beneficiaries. This allows CMS to review the benefit packages in a consistent way across all submitted bids during with incredibly
tight timeframes. This data is also used to populate data on Medicare Plan Finder, which allows beneficiaries to access and
compare Medicare Advantage and Prescription Drug plans. Form Number: CMS-R-262 (OMB control number: 0938-0763); Frequency: Yearly; Affected Public: Private sector, Business or other for-profits, Not-for-profits institutions; Number of Respondents: 764; Number of Responses: 8,068; Total Annual Hours: 44,178. (For policy questions regarding this collection contact Kristy Holtje at 410-786-2209 or kristy.holtje@cms.hhs.gov.)

1. Type of Information Collection Request: Reinstatement of a previously approved collection; Title of Information Collection: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums
   and Cost Sharing; Exchanges: Eligibility and Enrollment; Use: Information collected

   by the Exchanges, Medicaid or CHIP agencies will be used to determine eligibility for coverage through the Exchanges and insurance
   affordability programs (i.e., Medicaid, CHIP, and advance payment of the premium tax credits), and to assist consumers in enrolling in a QHP if eligible.
   Applicants include anyone who may be eligible for coverage through any of these programs. The Exchanges verify the information
   provided on the application, communicate with the applicant or his/her authorized representative and subsequently provide
   the information to the health plan selected by the applicant so that it can enroll him/her in a QHP. The Exchanges also use
   the information provided in support of its ongoing operations, including activities such as verifying continued eligibility
   for all programs, processing appeals, reporting on and managing the insurance affordability programs for eligible individuals,
   performing oversight and quality control activities, combating fraud, and responding to any concerns about the security or
   confidentiality of the information. Form Number: CMS-10468 (OMB control number: 0938-1207); Frequency: Annually; Affected Public: Individuals, Households and Private Sector; Number of Respondents: 20; Total Annual Responses: 20; Total Annual Hours: 25,614. (For policy questions regarding this collection contact Angela Meadows at Angela.Meadows@cms.hhs.gov.)

William N. Parham, III, Director, Division of Information Collections and Regulatory Impacts, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2026-05743 Filed 3-24-26; 8:45 am] BILLING CODE 4120-01-P

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