Availability of Information and the Criteria for Medical Necessity Determinations (§§ 438.915(a), 440.395(c)(1), and 457.496(e)(1))

Medical Necessity and Contract Amendments Under Mental Health Parity (CMS-10556)

OMB: 0938-1280

IC ID: 216059

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Availability of Information and the Criteria for Medical Necessity Determinations (§§ 438.915(a), 440.395(c)(1), and 457.496(e)(1))
 
No New
 
Mandatory
 
42 CFR 440.395(c)(1) 42 CFR 457.496(e)(1) 42 CFR 438.915(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

142,403 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 142,403 142,403 0 0 0 0
Annual IC Time Burden (Hours) 11,867 11,867 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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