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. New competitive private health insurance markets
(“Exchanges”) will give millions of Americans and small
businesses access to affordable, quality insurance options. Exchanges
will help individuals and small employers shop for, select, and
enroll in private health plans that fit their needs at competitive
prices. By providing a place for one-stop shopping, Exchanges will
make purchasing health insurance easier and more transparent, and
will put greater control and more choice in the hands of individuals
and small businesses.
Section
1301 of the Affordable Care Act (ACA) requires that all qualified
health plans (QHPs) be accredited by an accrediting entity that is
recognized by the Secretary of Health and Human Services.
In
order to recognize accrediting entities for the purposes of
certification of QHPs, HHS will require the accrediting entities to
submit documentation to HHS to demonstrate that they meet the
conditions for recognition. HHS also requires that the accrediting
entities provide certain data elements to the Exchanges once issuers
authorize the release of their accreditation survey data to the
Exchange. 45 CFR 156.275 requires a QHP issuer to authorize the
accrediting entity that accredits the QHP Issuer to release to the
Exchange its most recent accreditation survey data.
The
final rule that was released on July 20, 2012 establishes a process
for recognizing accrediting entities for the purposes of implementing
section 1311(c)(1)(D)(i) of the Affordable Care Act. In order for a
health plan to be certified as a QHP and operate in an Exchange, it
must be accredited by an accrediting entity that has been recognized
by the Secretary of Health and Human Services. The final rule
establishes the first phase of a two-phased process for recognition
of accrediting entities. In this first phase, the National Committee
for Quality Assurance (NCQA) and URAC have been recognized as
accrediting entities on an interim basis, subject to fulfilling the
documentation requirements in § 156.275(c)(4). This information
collection is necessary to ensure that the recognized accrediting
entities meet the proposed conditions. In addition, the final rule
requires that the accrediting entities provide accreditation survey
data elements, including accreditation status, accreditation score,
accreditation expiration date, clinical
quality measure results and adult and child CAHPS measure survey
results to
the Exchanges once these data are released by the issuers. Issuers
will also need to provide their Health Insurance Oversight System
(HIOS) issuer identifier to the accrediting entities so that their
accreditation data can be linked to other issuer data in the Exchange
system. This collection is necessary in order for Exchanges to
verify that the QHPs being offered in their Exchange meet the
accreditation requirement and are high quality plans.
2. Information
Users
The information will be used by:
1. HHS to ensure that the accrediting entities meet the conditions for recognition of accrediting entities established in the final rule; and
2.
Exchanges to verify that QHP issuers meet the accreditation
requirement for certification and to ensure that the QHPs are high
quality plans.
3. Use
of Information Technology
The
accrediting entities have the opportunity to submit their
documentation to HHS electronically as well as to electronically
transmit the accreditation survey data elements to the Exchange.
Issuers should be able to electronically submit their HIOS ID to the
accrediting entities.
There
is no duplication of efforts. This is a new data collection.
No
small businesses will be impacted by this collection of information.
Accrediting entities are the only entities impacted and do not meet
the criteria to qualify as small businesses.
There
are no special circumstances associated with this data collection.
8. Federal
Register/Outside Consultation
This
is a new collection. As required by the Paperwork Reduction Act
of 1995 (44 U.S.C.2506 (c)(2)(A)), the Center for Consumer
Information and Insurance Oversight (CCIIO) published this
information collection review (ICR) concurrently with publication of
the notice of proposed rulemaking (NPRM) and requested public
comment by August 1, 2012, on the information collection requirements
specified in the Data
Collection to Support Standards Related to Essential Health Benefits;
Recognition of Entities for the Accreditation of Qualified Health
Plans; Accreditation Requirement in the Federally-facilitated
Exchange PRA,
(OMB Control No. 0938-NEW). No public comments were received
regarding this ICR. In addition, both recognized accrediting
entities who submitted comments on the NPRM did not state anything
regarding the information collection burden and requirements.
No
payments or gifts were made to any respondents.
No
sensitive questions are asked in this data collection.
12. Burden
Estimates (Hours & Wages)
Burden
on Accrediting Entities
The
burden is on NCQA and URAC to submit documentation to HHS and also to
provide data from the accreditation survey to the Exchange.
As
stated in section 156.275(c)(5), HHS requires that NCQA and URAC
provide documentation on their current accreditation standards and
requirements, processes and measure specifications for performance
measures to demonstrate that each entity meets the proposed
conditions for recognition. Recognized accrediting entities will
also need to submit any proposed changes or updates to the
accreditation standards and requirements, processes, and measure
specifications 60 days prior to implementation. HHS expects that
these proposed changes would happen annually. The burden associated
with meeting this requirement includes the time and effort needed by
the accrediting entity to compile the documentation and submit the
information electronically to HHS. The only associated costs
are labor costs.
In addition, HHS is requiring that the
accrediting entities submit accreditation survey data elements to the
Exchanges. The burden associated with meeting this requirement
includes the time and effort to collect the HIOS ID from issuers,
organize the data to fill the templates provided by every Exchange
(we are assuming 51 State-based Exchanges) and submitting the data to
every Exchange on a monthly basis as these data are updated.
Data Element |
# of Employees Needed |
Cost of Reporting |
Burden Hours |
Cost of Reporting (per response) |
# of Responses per Respondent (per year) |
Total Burden Hours (per year) |
Total Burden Costs (per year) |
Documentation |
|
|
|
|
|
|
|
Compilation/ |
1 |
$55.00 |
2 |
$110.00 |
1 |
2 |
$110.00 |
SUBTOTAL |
|
|
2 |
$110.00 |
1 |
2 |
$110.00 |
Data Sharing |
|
|
|
|
|
|
|
Collect HIOS ID from Issuers |
1 |
$55.00 |
17 |
$940.00 |
1 |
17 |
$940.00 |
Organize Data Feed to Exchange |
1 |
$55.00 |
255 |
$14,025 |
1 |
255 |
$14,025 |
Submit Data to Exchange |
1 |
$55.00 |
51 |
$2,805 |
12 |
612 |
$33,660 |
SUBTOTAL |
|
|
323 |
$17,770 |
14 |
884 |
$48,625 |
Below
is the total estimate of the annual burden across the two accrediting
entities that are subject to the reporting requirements of this
rule.
Data Element |
# of Respondents |
Total Number of Responses (all Respondents |
Total Number of Hours |
Total Burden Cost (per year) |
Documentation |
2 |
2 |
4 |
$220.00 |
Data Sharing |
2 |
28 |
1,768 |
$97,250 |
TOTAL |
|
30 |
1772 |
$97,470 |
There
are no anticipated capital costs associated with this data
collection.
There
are no additional costs to the Federal government.
15. Changes
to Burden
This
is a new data collection resulting in an increase of 1772 annual
burden hours.
There
is no publication associated with this data
collection.
17. Expiration
Date
The
expiration date will be displayed.
18. Certification
Statement
There
are no exceptions to the certification statement identified in Item
19, "Certification for Paperwork Reduction Act Submissions,"
of OMB Form 83-I.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CMS |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |