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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:
0938-1094
ICR Reference No:
202108-0938-010
Status:
Historical Active
Previous ICR Reference No:
201904-0938-015
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCIIO
Title:
Notice of Rescission of Coverage and Disclosure Requirements for Patient Protection under the Affordable Care Act (CMS-10330)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
09/10/2021
OIRA Conclusion Action:
Approved with change
Conclusion Date:
09/16/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/09/2021
Terms of Clearance:
The agency will consider comments received as part of the associated rule as well as those received during the 60/30 comment periods as part of transitioning this into a standard package.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2022
6 Months From Approved
07/31/2022
Responses
15,752
0
70,612
Time Burden (Hours)
814
0
524
Cost Burden (Dollars)
4,371
0
6,857
Abstract:
Sections 2712 and 2719A of the Public Health Service Act (PHS Act), as added by the Affordable Care Act, contain rescission notice, and patient protection disclosure requirements that are subject to the Paperwork Reduction Act of 1995. The No Surprises Act, enacted as part of the Consolidated Appropriations Act, 2021, amended section 2719A of the PHS Act to sunset when the new emergency services protections under the No Surprises Act take effect. The provisions of section 2719A of the PHS Act will no longer apply with respect to plan years beginning on or after January 1, 2022. The No Surprises Act re-codified the patient protections related to choice of health care professional under section 2719A of the PHS Act in newly added section 9822 of the Internal Revenue Code, section 722 of the Employee Retirement Income Security Act, and section 2799A-7 of the PHS Act and extended the applicability of these provisions to grandfathered health plans for plan years beginning on or after January 1, 2022. The rescission notice will be used by health plans to provide advance notice to certain individuals that their coverage may be rescinded as a result of fraud or intentional misrepresentation of material fact. The patient protection notification will be used by health plans to inform certain individuals of their right to choose a primary care provider or pediatrician and to use obstetrical/gynecological services without prior authorization. The related provisions are finalized in the 2015 final regulations titled “Final Rules under the Affordable Care Act for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, and Patient Protections” (80 FR 72192, November 18, 2015) and 2021 interim final regulations titled “Requirements Related to Surprise Billing; Part I”. The 2015 final regulations also require that, if State law prohibits balance billing, or a plan or issuer is contractually responsible for any amounts balanced billed by an out-of-network emergency services provider, a plan or issuer must provide a participant, beneficiary or enrollee adequate and prominent notice of their lack of financial responsibility with respect to amounts balanced billed in order to prevent inadvertent payment by the individual. Plans and issuers will not be required to provide this notice for plan years beginning on or after January 1, 2022.
Emergency Justfication:
The Centers for Medicare & Medicaid Services (CMS) is requesting that an information collection request for some provisions in the Consolidated Appropriations Act of 2021 (Appropriations Act) enacted on December 27, 2020, related to the No Surprises Act be processed in accordance with the implementing regulations of the Paperwork Reduction Act of 1995 (PRA) at 5 CFR 1320.13(a)(2)(i). We believe that public harm will result if the standard, non-emergency clearance procedures are followed. CMS is also requesting waiver of the notice requirement set forth in 5 CFR 1320.13(d). Specifically, we are requesting emergency approval for the revisions to the information collection requirement related to notice of right to designate a primary care provider (45 CFR 149.310(a)(4)). The No Surprises Act extends the applicability of the patient protections for choice of health care professionals to grandfathered health plans. The requirement on plans and health insurance issuers to provide this notice applies for plan years (in the individual market, policy years) beginning on or after January 1, 2022. It is in public interest that individuals receive the protections under the No Surprises Act on the date on which those protections go into effect. Following the standard PRA process will not provide grandfathered plans and health insurance issuers, sufficient time to implement this new requirement.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 2711
Name of Law: No lifetime or annual limits.
PL:
Pub.L. 111 - 148 2712 86 FR 36872
Name of Law: Prohibition on rescissions.
PL:
Pub.L. 111 - 148 2719A
Name of Law: Patient Protections.
Citations for New Statutory Requirements:
PL: Pub.L. 116 - 260 No Surprises Act Name of Law: Consolidated Appropriations Act, 2021
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AU63
Final or interim final rulemaking
86 FR 36872
07/13/2021
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Section 2712 - Rules regarding rescissions
Section 2719A - Patient Protections
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
15,752
70,612
-54,860
0
0
0
Annual Time Burden (Hours)
814
524
290
0
0
0
Annual Cost Burden (Dollars)
4,371
6,857
-2,486
0
0
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:
No
Burden Reduction Due to:
Short Statement:
Burden hours for rescission notices have decreased by approximately 49 hours (from 294 to 245) annually because of a decrease in the estimated number of rescissions due to a decrease in the estimated number of individual market issuers and policies. Burden hours for one-time costs related to patient protection disclosure have increased by approximately 339 hours (from 230 to 569) annually due to an increase in the number of affected plans and issuers and use of updated data. Therefore, there is a total increase in burden of 290 hours.
Annual Cost to Federal Government:
$0
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.
No
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]?
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?
No
Agency Contact:
Jamaa Hill 301 492-4190
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:
09/09/2021
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