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Federal forms, ICRs, and supporting documents

Information Collection Request

Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008

ICR 201602-1545-027 · OMB 1545-2165 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Supporting Statement.doc Supporting Statement A Uploaded 2016-02-24 Available
IC Document Collections
IC IDCollectionTypeStatusForm
191315 Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008 Modified
ICR Details
1545-2165 201602-1545-027
Historical Active 201301-1545-004
TREAS/IRS
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
Revision of a currently approved collection   No
Regular
Approved without change 06/03/2016
Retrieve Notice of Action (NOA) 03/31/2016
  Inventory as of this Action Requested Previously Approved
06/30/2019 36 Months From Approved 06/30/2016
114,000 0 223,200
5,988 0 1,900
256,000 0 0
Section 9812 of the Code requires group health plans maintained by an employer with more than 50 employees to disclose upon request to participants and beneficiaries of the plan the medical necessity criteria used in making decisions regarding claims for benefits under the plan.
US Code: 26 USC 9812 Name of Law: Parity in the application of certain limits to mental health benefits
   PL: Pub.L. 110 - 343 511 Name of Law: Paul Wellstone and Pete Domenici Mental Health Parity and Addicition Equity Act of 2008
  
None
Not associated with rulemaking
  80 FR 74217 11/27/2015
81 FR 18694 03/31/2016
No
1
IC Title Form No. Form Name
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008
  Total Approved 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 114,000 223,200 0 0 -109,200 0
Annual Time Burden (Hours) 5,988 1,900 0 4,088 0 0
Annual Cost Burden (Dollars) 256,000 0 0 256,000 0 0
Yes
Miscellaneous Actions
No
This document contains final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which requires parity between mental health or substance use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations under group health plans and group and individual health insurance coverage. The final regulations retain the disclosure provisions for group health plans and health insurance coverage offered in connection with a group health plan. These changes will result in an increase in burden by 4,088 hours.
$0
No
No
No
No
No
Uncollected
Russell Weinheimer 202 622-6080
  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.
03/31/2016