Extension without change of a currently approved collection
Yes
Regular
11/26/2025
Requested
Previously Approved
36 Months From Approved
11/30/2025
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.
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