Essential Community Provider Data Collection to Support QHP Certification for PY 2017 (CMS-10561)

ICR 201508-0938-015

OMB: 0938-1295

Federal Form Document

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IC Document Collections
218061 New
ICR Details
0938-1295 201508-0938-015
Historical Active
Essential Community Provider Data Collection to Support QHP Certification for PY 2017 (CMS-10561)
New collection (Request for a new OMB Control Number)   No
Approved with change 12/09/2015
Retrieve Notice of Action (NOA) 09/01/2015
  Inventory as of this Action Requested Previously Approved
12/31/2018 36 Months From Approved
31,634 0 0
53,491 0 0
0 0 0

For plan years beginning on or after January 1, 2017, Health and Human Services (HHS) intends to collect more complete provider data for inclusion on the HHS Essential Community Provider (ECP) list to ensure a more accurate reflection of the universe of qualified available ECPs in a given service area that can be counted toward an issuer's satisfaction of the ECP standard. The HHS will collect data on qualified and available ECPs from providers. Providers will submit an ECP petition to be added to the HHS ECP list or provide required missing data fields to remain on the list. The degree of provider participation in this data collection effort through the ECP provider petition will help inform HHS's future proposals for counting issuers' ECP write-ins toward satisfaction of the ECP standard.

PL: Pub.L. 111 - 155 1311(c)(1)(C) Name of Law: Affordable Care Act
PL: Pub.L. 111 - 115 1311(c)(1)(c) Name of Law: Affordable Care Act

Not associated with rulemaking

  80 FR 32132 06/05/2015
80 FR 51275 08/24/2015

IC Title Form No. Form Name
Essential Community Provider Petition CMs-10561, CMS-10561 ECP Provider Petition ,   ECP Provider Petition Instructions

  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 31,634 0 31,634 0 0 0
Annual Time Burden (Hours) 53,491 0 53,491 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
This is a new data collection.

Jamaa Hill 301 492-4190


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.

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