Extension without change of a currently approved collection
Yes
Regular
11/26/2025
Requested
Previously Approved
36 Months From Approved
06/30/2026
2,755,048
163,546
1,691,251
89,520
58,518,032
556,147
The CAA added provisions applicable to group health plans and health insurance issuers in the group and individual markets in a new Part D of title XXVII of the Public Health Service Act (PHS Act) and also added new provisions to part 7 of the Employee Retirement Income Security Act (ERISA), and Subchapter B of chapter 100 of the Internal Revenue Code (Code). Section 102 of the No Surprises Act added Code section 9816, ERISA section 716, and PHS Act section 2799A-1, which contain limitations on cost sharing and requirements for initial payments for emergency services. Section 103 of the No Surprises Act amended Code section 9816, ERISA section 716, and PHS Act section 2799A-1 to establish a Federal independent dispute resolution (Federal IDR) process that nonparticipating providers or facilities and group health plans and health insurance issuers in the group and individual market may use following the end of an unsuccessful open negotiation period to determine the out-of-network rate for certain services. More specifically, the Federal IDR provisions may be used to determine the out-of-network rate for certain emergency services, nonemergency items and services furnished by nonparticipating providers at participating health care facilities, where an All-Payer Model Agreement or specified state law does not apply. Section 105 of the No Surprises Act created Code section 9817, ERISA section 717, and PHS Act section 2799A-2 which contain limitations on cost sharing and requirements for initial payments for air ambulance services, and allow plans and issuers and providers of air ambulance services to access the Federal IDR process. CAA provisions that apply to health care providers and facilities, and providers of air ambulance services, such as requirements around cost sharing, prohibitions on balance billing for certain items and services, and requirements related to disclosures about balance billing protections, were added to title XXVII of the PHS Act in a new part E.
The Departments have made the following changes to the estimates of the burden of the information collection:
⢠The Department have updated the average hour burden for the IDR notices from 2 hours to 30 minutes.
⢠The Departments have updated the wage rates and the number of IDR claims that are expected to go through the Federal IDR process.
⢠The Departments have combined the hour and cost burden for nonparticipating providers or nonparticipating emergency facilities and air ambulance providers.
⢠The Departments have also removed the hour burden for the additional information to be shared with the initial payment or notice of denial of payment, as the form has been included in OMB Control Number 0938-1433.
As a result, the number of responses has increased by 2,591,502 responses, the hour burden has increased by 1,601,731 hours, and the cost burden has increased by $57,961,885.
The Departments have combined the hour and cost burden for nonparticipating providers or nonparticipating emergency facilities and air ambulance providers. The Departments have also added the hour burden for the registration of group health plans and health insurance issuers. Finally, the Departments have removed the hour burden for the additional information to be shared with the initial payment or notice of denial of payment, as this burden will now be included in HHS OMB Control Number 0938-1401.
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
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.
Response to the Employee Benefits Security Administration (EBSA) Comment Request on Agency Information Collection Activities (1).msg
1210-0169 Tri-dept PRA supporting statement 11.13.2025 .docx
Additional Information to Be Shared with the Initial Payment or Notice of Denial of Payment