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Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Mental Health Parity and Addiction Equity Act of 2008 Notices
OMB: 1210-0138
IC ID: 191431
OMB.report
DOL/EBSA
OMB 1210-0138
ICR 202405-1210-001
IC 191431
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2590.712(d)(2)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,064,758
Number of Respondents for Small Entity:
990,225
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
58 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,064,758
0
0
13,469
0
1,051,289
Annual IC Time Burden (Hours)
88,730
0
0
1,123
0
87,607
Annual IC Cost Burden (Dollars)
412,924
0
0
83,345
0
329,579
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.