Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008

Mental Health Parity and Addiction Equity Act of 2008 Notices

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0138 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2590.712(d)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,051,289	Number of Respondents for Small Entity: 962,379

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 58 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,051,289	82,421	968,868
Annual IC Time Burden (Hours)	6,891	435	6,456
Annual IC Cost Burden (Dollars)	3,993,317	515,740	3,477,577

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.