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OMB Control No: 0938-1099	ICR Reference No: 202512-0938-019
Status: Received in OIRA	Previous ICR Reference No: 202504-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers (CMS-10338)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	489,980,891	0
Time Burden (Hours)	866,105	0
Cost Burden (Dollars)	142,092,824	0

ICR Summary of Burden

	Total Request	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	489,980,891	-26,600,175	516,581,066
Annual Time Burden (Hours)	866,105	-332,587	1,198,692
Annual Cost Burden (Dollars)	142,092,824	-7,714,008	149,806,832

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: Due to adjustments in the number of respondents and expected claims in the appeals and external review process based on recent data, HHS’s total annual hour burden has decreased from 1,198,692 hours to 866,105 hours. As a result, the annual total cost burden has decreased from $149,806,832 to $57,428,960.

Annual Cost to Federal Government: $9,230

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

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