Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008

ICR 201311-1210-006

OMB: 1210-0138

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2013-11-05
ICR Details
1210-0138 201311-1210-006
Historical Active 201211-1210-005
DOL/EBSA
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Revision of a currently approved collection   No
Regular
Approved without change 11/23/2013
Retrieve Notice of Action (NOA) 11/23/2013
  Inventory as of this Action Requested Previously Approved
11/30/2016 36 Months From Approved 03/31/2016
629,000 0 420,400
6,000 0 900
1,494,000 0 569,614

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008 (Division C of Public Law 110-343). MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Code). In 1996, Congress enacted the Mental Health Parity Act of 1996, which required parity in aggregate lifetime and annual dollar limits for mental health benefits and medical and surgical benefits. Those mental health parity provisions were codified in section 712 of ERISA, section 2705 of the PHS Act, and section 9812 of the Code. The changes made by MHPAEA are codified in these same sections and consist of new requirements as well as amendments to several of the existing mental health parity provisions applicable to group health plans and health insurance coverage offered in connection with a group health plan. MHPAEA and the interim final regulations do not apply to small employers who have between two and 50 employees. The changes made by MHPAEA are generally effective for plan years beginning after October 3, 2009. MHPAEA and the final regulations (29 CFR 2590.712(d)) require plan administrators to disclose the criteria for medical necessity determinations with respect to mental health and substance use disorder benefits. These third-party disclosures are information collection requests for purposes of the Paperwork Reduction Act.

PL: Pub.L. 110 - 343 512 Name of Law: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
  
PL: Pub.L. 110 - 343 512 Name of Law: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008

1210-AB30 Final or interim final rulemaking 78 FR 39869 07/02/2013

Yes

1
IC Title Form No. Form Name
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 629,000 420,400 208,547 53 0 0
Annual Time Burden (Hours) 6,000 900 5,099 1 0 0
Annual Cost Burden (Dollars) 1,494,000 569,614 924,261 125 0 0
Yes
Changing Regulations
No
The Interim Final Regulations only covered plans with more than 50 participants. The ACA under the Essential Health Benefits Regulation extended the provisions of MHPAEA to all non-grandfathered ERISA-covered plans. The increased burden is primarily due to including the burden for these plans in this ICR. Burden estimates also changed due to adjustments in wage rates and postage costs due to inflation.

$0
No
No
Yes
No
No
Uncollected
James Butikofer 202 693-8434 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/05/2013


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