Requirements Related to No Surprise Billing Act, Part II (CMS-10791)

ICR 202109-0938-015

OMB:

Federal Form Document

ICR Details
202109-0938-015
Historical Inactive
HHS/CMS
Requirements Related to No Surprise Billing Act, Part II (CMS-10791)
New collection (Request for a new OMB Control Number)   No
Emergency 10/11/2021
Withdrawn 10/07/2021
Retrieve Notice of Action (NOA) 10/07/2021
  Inventory as of this Action Requested Previously Approved
6 Months From Approved
0 0 0
0 0 0
0 0 0

The No Surprises Act adds a new Part E of title XXVII of the PHS Act establishing requirements applicable to health care providers, and facilities. Specifically, the No Surprises Act adds provisions at new PHS Act sections 2799B-6 and 2799B-7, which require providers and facilities to provide a good faith estimate of the total expected charges to uninsured individuals, under certain circumstances, upon their request, for scheduled items and services, and allow uninsured individuals to avail themselves to a patient-provider dispute resolution process if their billed charges after receiving such items or services is substantially in excess of the expected charges listed in the good faith estimate furnished by the provider or facility. PHS Act section 2799B-6 (2)(A) requires a health care provider or facility to provide a notification of the good faith estimate of expected charges to a plan or issuer in the case the individual is enrolled in such a plan or coverage and is seeking to have a claim for such item or services submitted to such plan or coverage. The good faith estimate of expected charges from the health care provider or facility will inform the advanced explanation of benefits that must be provided by the plan or issuer, as required by PHS Act section 2799A-1(f), in the case the individual is enrolled in such a plan or coverage and is seeking to have a claim for such item or services submitted to such plan or coverage.
Before January 1, 2022, the HHS needs to certify the independent dispute resolution (IDR) entities, therefore, the regulated community needs to prepare for the January 1, 2022 applicability date. If normal clearance procedures are followed, this statutory deadline may be missed and the IDR process and other regulatory provisions will not be available with its accompany protections.

PL: Pub.L. 116 - 260 103 Name of Law: Consolidated Appropriations Act - 2021
   PL: Pub.L. 116 - 260 105 Name of Law: Consolidated Appropriations Act - 2021
  
PL: Pub.L. 105 - 105 No Surprises Act Name of Law: Consolidated Appropriations Act - 2021

0938-AU62 Final or interim final rulemaking 86 FR 55980 10/07/2021

No

No
No
This is a new collection of information.

$12,000,000
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.
10/07/2021


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