The 2017 interim final regulations
titled “Religious Exemptions and Accommodations for Coverage of
Certain Preventive Services Under the Affordable Care Act” and
“Moral Exemptions and Accommodations for Coverage of Certain
Preventive Services Under the Affordable Care Act” expand
exemptions for religious beliefs and moral convictions for certain
entities or individuals whose health plans may otherwise be subject
to a mandate of contraceptive coverage through guidance issued
pursuant to the Patient Protection and Affordable Care Act. The
interim final rules extend the exemption to health insurance
issuers that hold religious or moral objections in certain
circumstances. The interim final rules also allow plan participants
and enrollees with sincerely held religious or moral objections to
request coverage that does not include contraceptive services. The
interim final rules also leave the accommodation process in place
as an optional process for objecting entities who wish to use it
voluntarily. To avoid contracting, arranging, paying, or referring
for contraceptive coverage, an organization seeking to be treated
as an eligible organization may self-certify (by using EBSA Form
700), prior to the beginning of the first plan year to which an
accommodation is to apply, that it meets the definition of an
eligible organization. The eligible organization must provide a
copy of its self-certification to each health insurance issuer that
would otherwise provide such coverage in connection with the health
plan (for insured group health plans or student health insurance
coverage). The issuer that receives the self-certification must
provide separate payments for contraceptive services for plan
participants and beneficiaries (or students and dependents). For a
self-insured group health plan, the self-certification must be
provided to its third party administrator. An eligible organization
may alternatively submit a notification to HHS as an alternative to
submitting the EBSA Form 700 to the eligible organization’s health
insurance issuer or third party administrator. A health insurance
issuer or third party administrator providing or arranging payments
for contraceptive services for participants and beneficiaries in
plans (or student enrollees and covered dependents in student
health insurance coverage) of eligible organizations must provide a
written notice to such plan participants and beneficiaries (or such
student enrollees and covered dependents) informing them of the
availability of such payments. Eligible organizations can revoke at
any time the accommodation process if participants and
beneficiaries receive written notice of such revocation from the
issuer or third party administrator in accordance with guidance
issued by the Secretary, and if the accommodation process is
currently being utilized, such revocation will be effective on the
first day of the first plan year that begins on or after thirty
days after the date of revocation.
The Centers for Medicare
& Medicaid Services (CMS) is requesting that an information
collection request associated with the coverage of certain
preventive services under the Affordable Care Act be processed in
accordance with the implementing regulations of the Paperwork
Reduction Act of 1995 at 5 CFR 1320.13(a)(2)(i). We believe public
harm is reasonably likely to occur if the normal, non-emergency
clearance procedures are followed. Specifically, we are requesting
emergency review and approval in order to implement provisions
regarding self-certification or notices to HHS from eligible
organizations (§147.131(c)(3)), notice of availability of separate
payments for contraceptive services (§147.131(e)), and notice of
revocation of accommodation (§147.131(c)(4)). Normal clearance
procedures will likely prevent or disrupt the collection of
information associated with §147.131(c)(3), §147.131(e), and
§147.131(c)(4). In accordance with 5 CFR 1320.13(a)(2)(i), we
believe that public harm is reasonably likely to ensue if the
normal clearance procedures is followed. The use of normal
clearance procedures is reasonably likely to prevent or disrupt the
collection of information. Similarly, in accordance with 5 CFR
1320.13(a)(2)(iii), we believe the use of normal clearance
procedures is reasonably likely to cause a statutory or court
ordered deadline to be missed. Many cases related to the provision
of contraceptive services have been on remand for over a year from
the Supreme Court asking the Departments of Health and Human
Services, Labor, and Treasury (the Departments) and the parties to
resolve this matter. The Departments are in the process of issuing
interim final rules that expand exemptions to entities, which
involves no collection of information and which the Departments
have statutory authority to do by the use of interim final rules.
If the information collection involved in the amended accommodation
process is not approved on an emergency basis, newly exempt
entities that wish to opt into the amended accommodation process
might not be able to do so until normal clearance procedures are
completed.
PL:
Pub.L. 111 - 148 1001 Name of Law: Amendments to the Public
Health Service Act
PL:
Pub.L. 111 - 148 1563 Name of Law: Conforming amendments
US Code: 42
USC 300gg-13 Name of Law: Coverage of preventive health
services
EO: EO 13765 Name/Subject of EO: Executive Order
Minimizing the Economic Burden of the Patient Protection and
Affordable Care Act Pen
EO: EO 13798 Name/Subject of EO: Executive Order
Promoting Free Speech and Religious Liberty
PL: Pub.L. 111 - 148 1001 Name of Law:
Amendments to the Public Health Service Act
PL: Pub.L. 111 - 148 1563 Name of Law: Conforming amendments
US Code: 42 USC 300gg-13 Name of Law: Coverage of preventive health
services
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.
Model Notice to HHS