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

Forms and Documents

Document Name	Status
MHPAEA_PRA_ss_1210-0138_11-05-2013.docx Supporting Statement A	2013-11-05

IC Document Collections

IC ID	Document Title	Status
191431	Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008	Modified

ICR Details

OMB Control No: 1210-0138	ICR Reference No: 201311-1210-006
Status: Historical Active	Previous ICR Reference No: 201211-1210-005
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/23/2013
	Date Received in OIRA: 11/23/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	36 Months From Approved	03/31/2016
Responses	629,000	0	420,400
Time Burden (Hours)	6,000	0	900
Cost Burden (Dollars)	1,494,000	0	569,614

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Abstract: 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.

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

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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB30	Final or interim final rulemaking	78 FR 39869	07/02/2013

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

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

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ICR Summary of Burden

	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

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 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.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/05/2013

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