Requirements Related to Surprise Billing; Part II (CMS-10791)
Reinstatement with change of a previously approved collection
No
Regular
07/07/2026
table that charts list comparision
Requested
Previously Approved
36 Months From Approved
1,023,497
0
3,498,944
0
372,398,687
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 ot 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.
The overall burden has decreased from 6,242,228 hours to 3,498,944 hours, resulting in a total burden reduction of 2,743,284 hours. Correspondingly, the associated cost has decreased from $676,943,115 to $270,538,405, a reduction of $406,404,710. This reduction is primarily due HHSâs assumption that providers and facilities have already incurred the one-time costs of generating notices to inform uninsured (or self-pay) individuals of their right to receive a GFE of expected charges. These initial costs also included displaying the notices on provider websites, in offices, and at locations where scheduling or cost inquiries occur; posting a one-page notice in at least two prominent locations; and printing and material expenses.
$0
No
No
No
Yes
No
No
No
Jamaa Hill 301 492-4190
Reginfo record details
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.
Patient-Provider Selected Dispute Resolution Entity Recertification