Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs (CMS-10558)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10558 QHP Network and Formulary - Developer Documentation	Form and Instruction	Modified	Available
CMS-10558 - Justification for Nonmaterial.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-11-18	Repair queued
CMS-10558 - Machine Readable 30 Day Public Comment Tracking Tool 09282015.pdf	Supplementary Document	Uploaded 2015-09-29	Available
CMS-10558 Crosswalk.xlsx	Supplementary Document	Uploaded 2015-06-29	Available
CMS-10558 - Response to comment document.pdf - Adobe Acrobat Pro.pdf	Supplementary Document	Uploaded 2015-06-29	Available
CMS-10558 - Machine Readable Supporting Statement Final 11182015.docx	Supporting Statement A	Uploaded 2015-11-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217257	QHP Network and Formulary - Developer Documentation	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1284	ICR Reference No: 201511-0938-009
Status: Historical Active	Previous ICR Reference No: 201506-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs (CMS-10558)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/07/2015
	Date Received in OIRA: 11/18/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	09/30/2017	09/30/2017
Responses	5,700	0	5,700
Time Burden (Hours)	98,800	0	98,800
Cost Burden (Dollars)	0	0	0

---

Abstract: 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. Under 45 CFR 156.122(d)(1)(2) and 156.230(c) in the rule Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016 (CMS-9944-P), new standards for qualified health plan (QHP) issuers are established for the submission of provider and formulary data in a machine- readable format to the Department of Health and Human Services (HHS) and for posting on issuer web sites.

---

Authorizing Statute(s): PL: Pub.L. 111 - 156 122, 230 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 16687	03/30/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 36810	06/26/2015
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
QHP Network and Formulary - Developer Documentation	CMS-10558	QHP Network and Formulary - Developer Documentation

---

ICR Summary of Burden

table that charts list 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	5,700	5,700	0	0	0	0
Annual Time Burden (Hours)	98,800	98,800	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a new collection of information.

---

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

---

Common Form ICR:  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:

(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: 11/18/2015

---