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OMB Control No: 0938-1433	ICR Reference No: 202606-0938-017
Status: Received in OIRA	Previous ICR Reference No: 202303-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Requirements Related to Surprise Billing; Part II (CMS-10791)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 07/07/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,023,497	0
Time Burden (Hours)	3,498,944	0
Cost Burden (Dollars)	372,398,687	0

Abstract: The No Surprises Act adds a new Part E of title XXVII of the PHS Act establishing requirements applicable to health care providers, and facilities. Specifically, the No Surprises Act adds provisions at new PHS Act sections 2799B-6 and 2799B-7, which require providers and facilities to provide a good faith estimate of the total expected charges to uninsured individuals, under certain circumstances, upon their request, for scheduled items and services, and allow uninsured individuals to avail themselves to a patient-provider dispute resolution process if their billed charges after receiving such items or services is substantially in excess of the expected charges listed in the good faith estimate furnished by the provider ot facility. PHS Act section 2799B-6 (2)(A) requires a health care provider or facility to provide a notification of the good faith estimate of expected charges to a plan or issuer in the case the individual is enrolled in such a plan or coverage and is seeking to have a claim for such item or services submitted to such plan or coverage. The good faith estimate of expected charges from the health care provider or facility will inform the advanced explanation of benefits that must be provided by the plan or issuer, as required by PHS Act section 2799A-1(f), in the case the individual is enrolled in such a plan or coverage and is seeking to have a claim for such item or services submitted to such plan or coverage.

Authorizing Statute(s): PL: Pub.L. 116 - 260 Title I of Division BB Name of Law: Consolidated Appropriations Act, 2021

Citations for New Statutory Requirements: US Code: 45 USC 149.610 Name of Law: Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) i

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:
	91 FR 5109	02/04/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 36144	06/16/2026
Did the Agency receive public comments on this ICR? Yes

ICR Summary of Burden

	Total Request	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,023,497	-2,987,194	4,010,691
Annual Time Burden (Hours)	3,498,944	-2,743,284	6,242,228
Annual Cost Burden (Dollars)	372,398,687	-304,544,428	676,943,115

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 overall burden has decreased from 6,242,228 hours to 3,498,944 hours, resulting in a total burden reduction of 2,743,284 hours. Correspondingly, the associated cost has decreased from $676,943,115 to $270,538,405, a reduction of $406,404,710. This reduction is primarily due HHS’s assumption that providers and facilities have already incurred the one-time costs of generating notices to inform uninsured (or self-pay) individuals of their right to receive a GFE of expected charges. These initial costs also included displaying the notices on provider websites, in offices, and at locations where scheduling or cost inquiries occur; posting a one-page notice in at least two prominent locations; and printing and material expenses.

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

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