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OMB Control No: 1210-0169	ICR Reference No: 202508-1210-009
Status: Received in OIRA	Previous ICR Reference No: 202302-1210-003
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: No Surprises Act: IDR Process
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: Yes
Type of Review Request: Regular	Date Submitted to OIRA: 11/26/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	2,755,048	163,546
Time Burden (Hours)	1,691,251	89,520
Cost Burden (Dollars)	58,518,032	556,147

Abstract: The CAA added provisions applicable to group health plans and health insurance issuers in the group and individual markets in a new Part D of title XXVII of the Public Health Service Act (PHS Act) and also added new provisions to part 7 of the Employee Retirement Income Security Act (ERISA), and Subchapter B of chapter 100 of the Internal Revenue Code (Code). Section 102 of the No Surprises Act added Code section 9816, ERISA section 716, and PHS Act section 2799A-1, which contain limitations on cost sharing and requirements for initial payments for emergency services. Section 103 of the No Surprises Act amended Code section 9816, ERISA section 716, and PHS Act section 2799A-1 to establish a Federal independent dispute resolution (Federal IDR) process that nonparticipating providers or facilities and group health plans and health insurance issuers in the group and individual market may use following the end of an unsuccessful open negotiation period to determine the out-of-network rate for certain services. More specifically, the Federal IDR provisions may be used to determine the out-of-network rate for certain emergency services, nonemergency items and services furnished by nonparticipating providers at participating health care facilities, where an All-Payer Model Agreement or specified state law does not apply. Section 105 of the No Surprises Act created Code section 9817, ERISA section 717, and PHS Act section 2799A-2 which contain limitations on cost sharing and requirements for initial payments for air ambulance services, and allow plans and issuers and providers of air ambulance services to access the Federal IDR process. CAA provisions that apply to health care providers and facilities, and providers of air ambulance services, such as requirements around cost sharing, prohibitions on balance billing for certain items and services, and requirements related to disclosures about balance billing protections, were added to title XXVII of the PHS Act in a new part E.

Authorizing Statute(s): PL: Pub.L. 116 - 260 103 and 105 Name of Law: Consolidated Appropriations Act, 2021

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:
	90 FR 671	01/06/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 54399	11/26/2025
Did the Agency receive public comments on this ICR? Yes

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,755,048	163,546	2,591,502
Annual Time Burden (Hours)	1,691,251	89,520	1,601,731
Annual Cost Burden (Dollars)	58,518,032	556,147	57,961,885

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: The Departments have made the following changes to the estimates of the burden of the information collection: • The Department have updated the average hour burden for the IDR notices from 2 hours to 30 minutes. • The Departments have updated the wage rates and the number of IDR claims that are expected to go through the Federal IDR process. • The Departments have combined the hour and cost burden for nonparticipating providers or nonparticipating emergency facilities and air ambulance providers. • The Departments have also removed the hour burden for the additional information to be shared with the initial payment or notice of denial of payment, as the form has been included in OMB Control Number 0938-1433. As a result, the number of responses has increased by 2,591,502 responses, the hour burden has increased by 1,601,731 hours, and the cost burden has increased by $57,961,885.

Annual Cost to Federal Government: $1,000,000

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]? 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: James Butikofer 202 693-8434 Butikofer.James@dol.gov

Common Form ICR: Yes
Description/Changes for Common Form Usage: The Departments have combined the hour and cost burden for nonparticipating providers or nonparticipating emergency facilities and air ambulance providers. The Departments have also added the hour burden for the registration of group health plans and health insurance issuers. Finally, the Departments have removed the hour burden for the additional information to be shared with the initial payment or notice of denial of payment, as this burden will now be included in HHS OMB Control Number 0938-1401.

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