Patient Protection and
Affordable Care Act Patient Protection Notice
Revision of a currently approved collection
No
Emergency
09/10/2021
08/24/2021
Requested
Previously Approved
6 Months From Approved
05/31/2022
128,133
734,800
3,534
6,546
1,602
4,005
The Patient Protection Notice is used
by health plan sponsors and issuers to notify certain individuals
of their right to (1) choose a primary care provider or a
pediatrician when a plan or issuer requires participants or
subscribers to designate a primary care physician; or (2) obtain
obstetrical or gynecological care without prior
authorization.
The No Surprises Act was
enacted on December 27, 2020, as title I of Division BB of the
Consolidated Appropriations Act, 2021. The cost-sharing and balance
billing requirements on plans, issuers, health care providers,
facilities, and providers of air ambulance services in the No
Surprises Act apply for plan years (in the individual market,
policy years) beginning on or after January 1, 2022. Although this
effective date may have allowed for the regulations, if promulgated
with the full notice and comment rulemaking process, to be
applicable in time for the applicability date of the provisions in
the No Surprises Act, this timeframe would not provide sufficient
time for the regulated entities to implement the requirements.
The No Surprises Act added
section 2799A-7 of the PHS Act, which contains the patient
protections regarding choice of health care professional from
section 2719A of the PHS Act. The patient protections under the No
Surprises Act apply generally to all group health plans and health
insurance coverage, including grandfathered health plans. The
Department believes that only plans that relinquish their
grandfathered status in 2021 and plans that are still grandfathered
in 2022 will become subject to this notice requirement for the
first time and incur the one-time costs to prepare the notice.
Burden numbers adjusted for the six-month emergency request.
$0
No
No
No
Yes
No
No
No
James Butikofer 202 693-8434
Butikofer.James@dol.gov
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.