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.docx	Supporting Statement A	Uploaded 2020-07-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
242614	Attestation - QHP Issuer		New
242611	Billing and Collection of the Separate Payment for Certain Contraceptive Services (State)		New
242609	Segregation Plan		New
242607	Billing and Collection of the Separate Payment for Certain Contraceptive Services (Issuers)		New

ICR Details

OMB Control No:	ICR Reference No: 202007-0938-001
Status: Received in OIRA	Previous ICR Reference No:
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: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/14/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	307	0
Time Burden (Hours)	4,225,900	0
Cost Burden (Dollars)	0	0

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Abstract: As directed by the rule Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (77 FR 18310) (Exchange rule), each Exchange assumed responsibilities related to the certification and offering of QHPs. Under 45 C.F.R. § 156.280(e)(5)(ii), each QHP issuer that offers non-excepted abortion services must submit to the State Insurance Commissioner a segregation plan describing how the QHP issuer establishes and maintains separate payment accounts for any QHP covering non-excepted abortion services, and pursuant to §156.280(e)(5)(iii), each QHP issuer must annually attest to compliance with PPACA section 1303 and applicable regulations. The Centers for Medicare and Medicaid Services (CMS) is including this information collection request (ICR) in connection with the segregation plan requirement under 45 C.F.R. § 156.280(e)(5)(ii). The burden estimate for this ICR included in this package reflects the time and effort for QHP issuers to submit a segregation plan that demonstrates how the QHP issuer segregates QHP funds in accordance with applicable provisions of generally accepted accounting requirements, circulars on funds management of the Office of Management and Budget and guidance on accounting of the Government Accountability Office. CMS is also including the ICR in connection with the annual attestation requirement under 45 C.F.R. § 156.280(e)(5)(iii). The burden estimate for this ICR reflects the time and effort associated with QHP issuers submitting an annual attestation to the State Insurance Commissioner attesting to compliance with section 1303 of the PPACA. In the Program Integrity Rule, CMS finalized at §156.280(e)(2)(ii) amendments relating to billing of the policy holder’s portion of the premium attributable to non-Hyde abortion services. To reflect the final rule, CMS is including proposed ICRs to reflect the finalized policies and to account for the revised burden to QHP issuers for implementing the separate billing policy.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1303 Name of Law: Patient Protection and Affordable Care Act
   US Code: 45 USC 156.280 Name of Law: Separate billing and segregation of funds for abortion services
  

Citations for New Statutory Requirements: US Code: 45 USC 156.280 Name of Law: Separate billing and segregation of funds for abortion services
PL: Pub.L. 111 - 148 1303 Name of Law: Patient Protection and 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
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 56015	11/09/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 71674	12/27/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

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

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	307	0	307	0	0	0
Annual Time Burden (Hours)	4,225,900	0	4,225,900	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.

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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: 07/14/2020

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