Information Collection Request

Mental Health Parity and Addiction Equity Act of 2008 Notices

ICR 201706-1210-001 · OMB 1210-0138 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Table of Comments for MHPAEA Model Template 09-03-2019.xlsx Supplementary Document Uploaded 2019-09-03 Available
FAQ 39 Compare - Track Changes - 9-3-19.docx Supplementary Document Uploaded 2019-09-03 Available
FAQs Part 39 - FINAL.docx Supplementary Document Uploaded 2019-08-27 Available
aca-part-39-proposed.pdf Supplementary Document Uploaded 2018-04-24 Available
Appendix II Crosswalk of Changes 4-16-18.docx Supplementary Document Uploaded 2018-04-18 Available
1210-0138 MHPAEA Supporting Statement 7-16-2019.docx Supporting Statement A Uploaded 2019-07-16 Available

IC Document Collections

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2022 36 Months From Approved 03/31/2020
1,217,876 0 955,207
27,207 0 5,544
3,477,577 0 3,424,759





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Mental Health and Substance Abuse Disorder Parity Disclosure Request, Model Notice

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 1,217,876 955,207 0 262,669 0 0
Annual Time Burden (Hours) 27,207 5,544 0 21,663 0 0
Annual Cost Burden (Dollars) 3,477,577 3,424,759 0 52,818 0 0


Reginfo record details
  No