Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10653)

ICR 202111-0938-010

OMB: 0938-1344

Federal Form Document

ICR Details
0938-1344 202111-0938-010
Received in OIRA 201804-0938-006
HHS/CMS CCIIO
Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10653)
Extension without change of a currently approved collection   No
Regular 11/19/2021
  Requested Previously Approved
36 Months From Approved 11/30/2021
595,312 777,367
72 181
151,209 196,723

Each organization seeking to be treated as an eligible organization that wishes to use the optional accommodation process offered under these final rules must either use the EBSA Form 700 method of self-certification or provide notice to HHS of its religious objection to coverage of all or a subset of contraceptive services.

EO: EO 13798 Name/Subject of EO: Executive Order Promoting Free Speech and Religious Liberty
   PL: Pub.L. 111 - 148 1001 Name of Law: Amendments to the Public Health Service Act
   PL: Pub.L. 111 - 148 1563 Name of Law: Conforming amendments
   US Code: 42 USC 300gg-13 Name of Law: Coverage of preventive health services
   EO: EO 13765 Name/Subject of EO: Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pen
  
PL: Pub.L. 111 - 148 1001 Name of Law: Amendments to the Public Health Service Act
PL: Pub.L. 111 - 148 1563 Name of Law: Conforming amendments
US Code: 42 USC 300gg-13 Name of Law: Coverage of preventive health services

Not associated with rulemaking

  86 FR 43256 08/06/2021
86 FR 64940 11/19/2021
Yes

  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 595,312 777,367 0 -4 -182,051 0
Annual Time Burden (Hours) 72 181 0 0 -109 0
Annual Cost Burden (Dollars) 151,209 196,723 0 -1 -45,513 0
No
No
There is a reduction in burden of 109 hours due to the assumption that no new revocation notices will be sent.

$0
No
    No
    No
Yes
No
No
No
William Parham 410 786-4669 [email protected]

  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.
11/19/2021


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