Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)

ICR 202104-0938-001

OMB: 0938-1393

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2021-04-02
Supporting Statement A
2021-04-02
ICR Details
0938-1393 202104-0938-001
Active
HHS/CMS CCIIO - 10773
Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)
New collection (Request for a new OMB Control Number)   No
Emergency 04/02/2021
Approved with change 04/02/2021
Retrieve Notice of Action (NOA) 04/02/2021
  Inventory as of this Action Requested Previously Approved
10/31/2021 6 Months From Approved
36,461 0 0
1,013,185 0 0
0 0 0

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.

PL: Pub.L. 116 - 260 203 Name of Law: Consolidated Appropriations Act, 2021
  
PL: Pub.L. 116 - 260 203 Name of Law: Consolidated Appropriations Act, 2021

Not associated with rulemaking

No

  Total Approved 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 36,461 0 36,461 0 0 0
Annual Time Burden (Hours) 1,013,185 0 1,013,185 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new collection of information.

No
    No
    No
Yes
No
No
No
Jamaa Hill 301 492-4190

  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:
 
 
 
 
 
 
 
    (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.
04/02/2021


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