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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:
0938-1099
ICR Reference No:
201106-0938-021
Status:
Historical Active
Previous ICR Reference No:
201009-0938-010
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
07/01/2011
OIRA Conclusion Action:
Approved with change
Conclusion Date:
11/17/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/22/2011
Terms of Clearance:
In accordance with 5 CFR 1320, the information collection is approved. Please note: This approval corrects a previous errors in (1) the annual cost burden -- the prior estimate incorrectly included monetized burden hours, and (2) annual time burden and number of responses -- the previous estimates were for three years cumulatively, rather than an annual average across the three years of approval, which significantly overstated the burden of this collection.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2012
6 Months From Approved
11/30/2011
Responses
70,834,597
0
211,216,845
Time Burden (Hours)
930,267
0
2,762,824
Cost Burden (Dollars)
36,775,067
0
109,200,000
Abstract:
The information collection requirements included in the claims procedure regulation ensure that participants and beneficiaries (claimants) receive information regarding the plan's claims procedures and the plan's handling of specific benefit claims. This collection is necessary for the Federal external review process to provide an independent external review as requested by claimants.
Emergency Justfication:
Please see the attached emergency justification.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 2719
Name of Law: Appeals process
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AQ66
Final or interim final rulemaking
76 FR 37208
06/24/2011
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
Disclosure for 2012
Disclosures and Review Burden (2011-2013)
Disclosures for 2011
Recordkeeping Requirements
States With External Review Laws - 2011
CMS-10338
CMS-10338.Deliberative Document
States With External Review Laws - 2012
CMS-10338
CMS-10338.Deliberative Document
States With External Review Laws - 2013
CMS-10338
CMS-10338.Deliberative Document
States With No External Review Laws - 2012
CMS-10338
CMS-10338.Deliberative Document
States With No External Review Laws - 2011
CMS-10338
CMS-10338.Deliberative Document
States With No External Review Laws - 2013
CMS-10338
CMS-10338.Deliberative Document
ICR Summary of Burden
Total Approved
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
70,834,597
211,216,845
0
-140,814,845
432,597
0
Annual Time Burden (Hours)
930,267
2,762,824
0
-1,562,824
-269,733
0
Annual Cost Burden (Dollars)
36,775,067
109,200,000
0
-58,100,000
-14,324,933
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Changing Regulations
Short Statement:
This approval corrects a previous errors in (1) the annual cost burden -- the prior estimate incorrectly included monetized burden hours, and (2) annual time burden and number of responses -- the previous estimates were for three years cumulatively, rather than an annual average across the three years of approval, which significantly overstated the burden of this collection.
Annual Cost to Federal Government:
$3,782
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
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?
Uncollected
Agency Contact:
William Parham 4107864669
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:
06/22/2011
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