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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1545-2165
ICR Reference No:
202309-1545-007
Status:
Historical Inactive
Previous ICR Reference No:
202207-1545-007
Agency/Subagency:
TREAS/IRS
Agency Tracking No:
Title:
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Comment filed on proposed rule and continue
Conclusion Date:
12/18/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/19/2023
Terms of Clearance:
OIRA will review the ICR again upon finalization of the rule.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2025
36 Months From Approved
10/31/2025
Responses
1,413,420
0
1,413,420
Time Burden (Hours)
31,574
0
31,574
Cost Burden (Dollars)
4,235,310
0
4,235,310
Abstract:
Section 9812 of the Code requires group health plans maintained by an employer with more than 50 employees to disclose upon request to participants and beneficiaries of the plan the medical necessity criteria used in making decisions regarding claims for benefits under the plan.
Authorizing Statute(s):
PL:
Pub.L. 110 - 343 511 and 512
Name of Law: Paul Wellstone and Pete Domenici Mental Health Parity and Addicition Equity Act of 2008
US Code:
26 USC 9812
Name of Law: Parity in the application of certain limits to mental health benefits
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
1545-BQ29
Proposed rulemaking
88 FR 51552
08/03/2023
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The Departments are proposing amendments to regulations implementing MHPAEA and proposes new regulations for the comparative analyses required under MHPAEA, as amended by the CAA, 2021. Specifically, this rule would amend existing and add new definitions, amend the existing NQTL standard to prevent plans and issuers from using NQTLs to place greater limits on access to MH/SUD benefits as compared to medical/surgical benefits, and add additional examples on the application of NQTLs to clarify and safeguard the protections of MHPAEA. Additionally, these proposed rules would set forth the content requirements for the comparative analyses and specify how plans and issuers must make these comparative analyses available to the Departments, any applicable State authority, and to participants, beneficiaries, and enrollees. In addition, the data inputs, mailing costs, and wage rates have been updated. As a result, the number of responses has decreased by 90,267, the hour burden has decreased by 909,981 hours, and the cost burden has decreased by $-3,905,731.
Annual Cost to Federal Government:
$26,913,080
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.
Yes
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]?
No
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
Agency Contact:
Mara Blumenthal 202 693-8538 blumenthal.mara@dol.gov
Common Form ICR:
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:
(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:
09/19/2023
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