View Information Collection Request (ICR) Package

OMB Control No: 0938-1284	ICR Reference No: 202403-0938-014
Status: Received in OIRA	Previous ICR Reference No: 202011-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: 10558
Title: Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs (CMS-10558)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/27/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2024
Responses	5,208	4,512
Time Burden (Hours)	39,126	31,484
Cost Burden (Dollars)	3,474,257	0

Abstract: On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act (P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable Care Act. The Affordable Care Act implements various policies that will make health insurance coverage more accessible to consumers. Under 45 CFR 156.122(d)(1)(2) and 156.230(c) in the rule Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016 (CMS-9944-P), new standards for qualified health plan (QHP) issuers are established for the submission of provider and formulary data in a machine- readable format to the Department of Health and Human Services (HHS) and for posting on issuer web sites.

Authorizing Statute(s): PL: Pub.L. 111 - 156 122, 230 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 75597	11/03/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 21254	03/27/2024
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
QHP Network and Formulary - Developer Documentation	CMS-10558	Schema Screenshots

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	5,208	4,512	696
Annual Time Burden (Hours)	39,126	31,484	7,642
Annual Cost Burden (Dollars)	3,474,257	0	3,474,257

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 increased by 7,642 hours (from 31,484 hours to 39,126 hours). This change is mainly due to more issuers (376 in the previously approved package compared to 434 in this current request) participating in the health insurance Exchanges. In addition, because the burden is calculated separately for the 219 QHP issuers and 215 SADP issuers on the Exchanges, the increased burden reflects greater growth in QHP issuers (175 in the previously approved package compared to 219 in this current request, an increase of 25 percent) compared with SADP issuers (201 in the previously approved package compared to 215 in this current request, an increase of 7 percent). Because SADP issuers are not required to make updated formulary information available to consumers and to CMS, we estimate that SADP issuers will require no pharmacist burden hours and will require half the burden hours estimated for QHPs for the remaining labor categories (per respondent). As a result of including more total issuers in the calculations, and proportionally higher numbers of QHP issuers, specifically, whose organizations will bear a higher reporting burden, the total three-year cost has increased from $2,780,537.46 to $3,474,187.52.

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

View ICR - Agency Submission