Regulatory Collection Filing

No Surprise Act: IDR Process

RCF 202203-1545-007CF · Host ICR 202110-1210-002 · OMB 1210-0169

RCF Summary

Host OMB Control No.	1210-0169
Host ICR Reference No.	202110-1210-002
Agency/Subagency	TREAS/IRS
Status	Received in OIRA
Type of RCF	RCF New
OIRA Conclusion Action	View RCF focusMethod = function getFocus() { document.getElementById("main").focus(); } .skip-main { border-color: transparent;
Date Received in OIRA	1969-12-31
Conclusion Date	1969-12-31
Related Links	OMB 1210-0169 · ICR 202110-1210-002

RCF Details

View RCF - Agency Submission

Title: No Surprise Act: IDR Process

Type of RCF: RCF New

Description of Agency Usage: IRS will be using the IDR model notices for health care providers, health facilities and self-pay individuals.

Authorizing Statute(s): PL: Pub.L. 116 - 260 103 and 105 Name of Law: Consolidated Appropriations Act 2021

Annual Cost to Federal Government: $0
Agency Contact: Kevin Knopf 202 317-5500 [email protected]

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name

RCF Summary of Burden:

	Total Request	Change Due to New Statute
Annual Number of Responses	18,338	18,338
Annual Time Burden (Hours)	32,974	32,974
Annual Cost Burden (Dollars)	99,300	99,300

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection.