Supporting Statement for Billing and Collection of the Separate Payment for Certain Abortion Services (CMS-10681)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10681 - Supporting Statement PI Rule (CMS-9922P).docx	Supporting Statement A	Uploaded 2018-11-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234036	Billing and Collection of the Separate Payment for Certain Contraceptive Services		New

ICR Details

OMB Control No: 0938-1358	ICR Reference No: 201811-0938-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: 10681
Title: Supporting Statement for Billing and Collection of the Separate Payment for Certain Abortion Services (CMS-10681)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule	Conclusion Date: 03/06/2019
	Date Received in OIRA: 11/19/2018
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: In accordance with proposed §156.280(e)(2), affected QHP issuers would be required to separately bill for (in a separate mailing or separate electronic communication) and instruct policy subscribers to separately pay for the portion of the enrollee’s premium attributed to non-Hyde abortion services. Under this proposal, QHP issuers would be required to send this separate bill in a separate mailing that requires additional postage. If a QHP issuer sends bills electronically, we propose that it provide consumers with the two bills in separate emails or other electronic communications. Under this proposal, the QHP issuer would also be required to produce an invoice or bill that is distinctly separate from the invoice or bill for the other portion of the consumer’s premium that is not attributable to non-Hyde abortion coverage, whether in paper or electronic format.

---

Authorizing Statute(s): US Code: 45 USC 156 Name of Law: Health Insurance Issuer Standards under the Affordable Care Act
   PL: Pub.L. 111 - 156 1303 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 156 1303 Name of Law: Patient Protection and Affordable Care Act
US Code: 45 USC 156 Name of Law: Health Insurance Issuer Standards under the Affordable Care Act

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT53	Proposed rulemaking	83 FR 56015	11/09/2018

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Billing and Collection of the Separate Payment for Certain Contraceptive Services

---

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 information collection request.

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 11/19/2018

---