The Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
(P.L.110-343) generally requires that group health plans and group
health insurance issuers offering mental health or substance use
disorder (MH/SUD) benefits in addition to medical and surgical
(med/surg) benefits do not apply any more restrictive financial
requirements (e.g., co-pays, deductibles) and/or treatment
limitations (e.g., visit limits, prior authorizations) to MH/SUD
benefits than those requirements and/or limitations applied to
substantially all med/surg benefits. The Patient Protection and
Affordable Care Act, Pub. L. 111-148, was enacted on March 23,
2010, and the Health Care and Education Reconciliation Act of 2010,
Pub. L. 111-152, was enacted on March 30, 2010. These statutes are
collectively known as the “Affordable Care Act.” The Affordable
Care Act extended MHPAEA to apply to the individual health
insurance market. The Consolidated Appropriations Act of 2021 (the
Appropriations Act) was enacted on December 27, 2020. The
Appropriations Act amended MHPAEA, in part, by expressly requiring
group health plans and health insurance issuers offering group or
individual health insurance coverage that offer both
medical/surgical benefits and MH/SUD benefits and that impose
non-quantitative treatment limitations (NQTLs) on MH/SUD benefits
to perform and document their comparative analyses of the design
and application of NQTLs. Further, beginning 45 days after the date
of enactment of the Appropriations Act, group health plans and
health insurance issuers offering group or individual health
insurance coverage must make their comparative analyses available
to the Departments of Labor, Health and Human Services (HHS), and
the Treasury or applicable state authorities, upon request. The
Appropriations Act also requires the Secretary of HHS to submit to
Congress, and make publicly available, an annual report on the
conclusions of the reviews.
The Centers for Medicare
& Medicaid Services (CMS) is requesting that an information
collection request for the provisions in the Consolidated
Appropriations Act of 2021 (Appropriations Act) enacted on December
27, 2020, related to comparative analyses with respect to
non-quantitative treatment limitations (NQTL) on mental health or
substance use disorder (MH/SUD) benefits be processed in accordance
with the implementing regulations of the Paperwork Reduction Act of
1995 (PRA) at 5 CFR 1320.13(a)(2)(iii). We believe that if the
normal, non-emergency clearance procedures are followed, CMS will
be unable to conduct the statutorily required reviews of the NQTL
analyses and submit to Congress, and make publicly available, a
report on the conclusions of the reviews in 2021 by the statutory
deadline of December 27, 2021. CMS is requesting a determination by
March 29, 2021. CMS is also requesting waiver of the notice
requirement set forth in 5 CFR 1320.13(d). Specifically, we are
requesting emergency approval for the information collection
requirements (ICRs) in section 203 of Title II of Division BB of
the Appropriations Act requiring group health plans and health
insurance issuers offering group or individual health insurance
coverage that offer both medical/surgical benefits and MH/SUD
benefits and that impose NQTLs on MH/SUD benefits to perform and
document their comparative analyses of the design and application
of NQTLs, and to make their comparative analyses available to the
Departments of Labor, Health and Human Services (HHS), and the
Treasury (collectively, the Departments) or applicable state
authorities, upon request. The Departments are required to conduct
reviews each year and submit to Congress and make publicly
available a report on the conclusions of those reviews. In order to
submit the report to Congress before December 27, 2021, CMS will
need to start conducting the reviews no later than May 2021. The
normal PRA clearance process will not allow CMS to complete all
reviews in time to meet the statutory deadline. The Department of
Labor is also seeking emergency review and approval, and waiver of
the notice requirement set forth in 5 CFR 1320.13(d), for the PRA
package that will account for their reviews.
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.
CMS-10773 - Emergency Justification.pdf
CMS-10773 NQTL Analysis Review Supporting Statement - Emergency.docx
Notification of Non-compliance (Self-Insured Non-Federal Governmental Plans and Issuers)