Patient Protection and Affordable Care Act Patient Protection Notice

ICR 202111-1545-007

OMB: 1545-2181

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2021-11-24
Supporting Statement A
2021-11-30
IC Document Collections
ICR Details
1545-2181 202111-1545-007
Received in OIRA 201705-1545-040
TREAS/IRS
Patient Protection and Affordable Care Act Patient Protection Notice
Reinstatement without change of a previously approved collection   No
Emergency 12/01/2021
12/01/2021
  Requested Previously Approved
6 Months From Approved
128,133 0
3,534 0
1,602 0

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.

PL: Pub.L. 111 - 148 10101(g) Name of Law: Affordable Care Act
   PL: Pub.L. 116 - 260 No Surprises Act Name of Law: Consolidated Appropriations Act, 2021
  
PL: Pub.L. 116 - 260 No Suprises Act Name of Law: Consolidated Appropriations Act, 2021

1545-BQ04 Final or interim final rulemaking 86 FR 36872 07/13/2021

No

1
IC Title Form No. Form Name
Patient Protection and Affordable Care Act Patient Protection Notice (TD 9951)

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 128,133 0 -564,874 0 0 693,007
Annual Time Burden (Hours) 3,534 0 -1,639 0 0 5,173
Annual Cost Burden (Dollars) 1,602 0 -3,769 0 0 5,371
No
No
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 Agency 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.

$0
No
    No
    No
Yes
No
No
No
Kari DiCecco 202 317-5500 kari.l.dicecco@irscounsel.treas.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.
12/01/2021


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