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

Forms and Documents

Document Name	Status
CMS-10681 Separate Billing_Supporting Statement doc.docx Supporting Statement A	2020-04-06

IC Document Collections

IC ID	Document Title	Status
241137	Billing and Collection of the Separate Payment for Certain Contraceptive Services (State)	New
241135	Segregation Plan	New
234036	Billing and Collection of the Separate Payment for Certain Contraceptive Services (Issuers)	Modified

ICR Details

OMB Control No: 0938-1358	ICR Reference No: 202004-0938-002
Status: Historical Inactive	Previous ICR Reference No: 201811-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Supporting Statement for Billing and Collection of the Separate Payment for Certain Abortion Services (CMS-10681)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 06/25/2020
	Date Received in OIRA: 04/06/2020
Terms of Clearance:

	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

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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.

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Authorizing Statute(s): 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
  

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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT53	Final or interim final rulemaking	84 FR 71674	12/27/2019

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Billing and Collection of the Separate Payment for Certain Contraceptive Services (Issuers)
Segregation Plan
Billing and Collection of the Separate Payment for Certain Contraceptive Services (State)

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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: The original burden estimate in the proposed rule would not accurately reflect the actual costs issuers would have incurred if we finalized the provisions as proposed. We have updated the estimates to reflect an increase in burden and costs for issuers and states performing premium billing and payment processing. Therefore, from the proposed to final rule, the total number of burden has increased from a one-time burden to issuers of 750 hours to 2,961,000 hours, as well as an annual burden to issuers of 53,328 hours to an average of 1,169,820 hours. In addition, CMS is merging the ICR associated with the segregation plan requirements under 45 CFR §156.280(e)(5)(ii) with the ICR for the separate billing policy CMS-10681/OMB control number: 0938-NEW finalized in the Patient Protection and Affordable Care Act; Exchange Program Integrity (Program Integrity Rule) (CMS-9922-F), at § 156.280(e)(2)(ii). Upon approval of the ICR, CMS will request to discontinue the segregation plan ICR CMS-10400/OMB control number: 0938-1156. No substantive changes were made to the collection other than merging the packages. Burden increased by 580 hours as a result of merging the segregation plan requirements into this ICR.

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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? No

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Common Form ICR:  No

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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: 04/06/2020

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