[Federal Register Volume 82, Number 117 (Tuesday, June 20, 2017)]
[Notices]
[Pages 28095-28097]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-12773]
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DEPARTMENT OF LABOR
Employee Benefits Security Administration
Proposed Revision of Information Collection Request Submitted for
Public Comment; Draft Model Non-Quantitative Treatment Limitations Form
AGENCY: Employee Benefits Security Administration, Department of Labor.
ACTION: Notice.
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SUMMARY: The Department of Labor (the Department), in accordance with
the Paperwork Reduction Act of 1995 (PRA 95), provides the general
public and Federal agencies with an opportunity to comment on proposed
and continuing collections of information. This helps the Department
assess the impact of its information collection requirements and
minimize the reporting burden on the public and helps the public
understand the Department's information collection requirements and
provide the requested data in the desired format. Currently, the
Employee Benefits Security Administration is soliciting comments on a
revision of the Notices under the Mental Health Parity and Addiction
Equity Act of 2008 information collection request (ICR) to add a model
form participants and authorized representatives can use to request
certain information from their health plans that is discussed below.
A copy of the information collection request (ICR) may be obtained
by contacting the office listed in the ADDRESSES section of this
notice. The ICR is also available on the Department's Web site at:
https://www.dol.gov/agencies/ebsa.
DATES: Written comments must be submitted to the office shown in the
Addresses section on or before September 1, 2017.
ADDRESSES: Direct all written comments regarding the information
collection request and burden estimates to the Office of Policy and
Research, Employee Benefits Security Administration, U.S. Department of
Labor, 200 Constitution Avenue NW., Room N-5718, Washington, DC 20210.
Telephone:
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(202) 693-8410; Fax: (202) 219-4745. These are not toll-free numbers.
Comments may also be submitted electronically to the following Internet
email address: [email protected].
SUPPLEMENTARY INFORMATION:
I. Background
The Paul Wellstone and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008 (MHPAEA) was enacted on October 3, 2008
and amended by the Affordable Care Act and the 21st Century Cures Act
(Cures Act). Generally, MHPAEA requires that the financial requirements
and treatment limitations imposed on mental health and substance use
disorder (MH/SUD) benefits cannot be more restrictive than the
predominant financial requirements and treatment limitations that apply
to substantially all medical and surgical benefits. As discussed below,
MHPAEA includes several disclosure requirements for group health plans
and health insurance issuers.
The Cures Act \1\ was enacted on December 13, 2016. Among its
requirements, the Cures Act contains provisions that are intended to
improve compliance with MHPAEA by requiring the Departments to solicit
feedback from the public on how to improve the process for group health
plans and issuers to disclose the information required under MHPAEA and
other laws.
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\1\ Public Law 114-255.
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The statutory MHPAEA provisions and implementing regulations
expressly provide that a plan or issuer must disclose the criteria for
medical necessity determinations with respect to MH/SUD benefits to any
current or potential participant, beneficiary, or contracting provider
upon request and must disclose the reason for any denial of
reimbursement or payment for services with respect to MH/SUD benefits
to the participant or beneficiary.
On October 27, 2016, the Departments of Labor, Health and Human
Services, and the Treasury (the Departments) issued Affordable Care Act
Implementation FAQs Part 34, which, among other things, solicited
feedback regarding disclosures with respect to MH/SUD benefits under
MHPAEA and other laws. In the FAQs, the Departments indicated that they
had received questions and suggestions regarding disclosures with
respect to Nonquantitative Treatment Limitation (NQTLs) applicable to
medical/surgical and MH/SUD benefits under the plan. The feedback also
included requests from various stakeholders for model forms that group
health plan participants, beneficiaries, covered individuals in the
individual market, or persons acting on their behalf could use to
request relevant disclosures. Stakeholders also requested guidance on
other ways in which disclosures, or the process for requesting
disclosures, could be more uniform, streamlined, or otherwise
simplified.
In addition, the Departments indicated that they had received
requests to explore ways to encourage uniformity among State reviews of
health insurance issuers' compliance with the NQTL standards. Various
stakeholders stated that model forms to report NQTL information will
help facilitate uniform implementation and enforcement of MHPAEA, and
relieve some complexity that MHPAEA compliance poses for issuers
operating in multiple States. Furthermore, other stakeholders
highlighted that the use of such model forms may also benefit
consumers, as consumers will be entitled to request the analysis
performed to complete the model forms.
The Cures Act requires the Departments, by June 13, 2017, to
solicit feedback from the public on how the disclosure request process
for documents containing information that health plans and health
insurance issuers are required under Federal or State law to disclose
to participants, beneficiaries, contracting providers or authorized
representatives to ensure compliance with existing mental health parity
and addiction equity requirements can be improved while continuing to
ensure consumers' rights to access all information required by Federal
or State law to be disclosed.\2\ The Cures Act requires the Departments
to make this feedback publicly available by December 13, 2017.\3\
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\2\ Cures Act section 13001(c)(1).
\3\ Cures Act section 13001(c)(2). The Departments must also
share this feedback with the National Association of Insurance
Commissioners (NAIC) to the extent the feedback includes
recommendations for the development of simplified information
disclosure tools to provide consistent information to consumers.
Such feedback may be taken into consideration by the NAIC and other
appropriate entities for the voluntary development and voluntary use
of common templates and other sample standardized forms to improve
consumer access to plan information. See Cures Act section
13001(c)(3).
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The Departments recently issued Affordable Care Act Implementation
FAQs Part 38, which again solicited comments on FAQs Part 34 as
required by the Cures Act. The Departments also solicited comments on a
draft model form that participants, enrollees, or their authorized
representatives could use to request information from their health plan
or issuer regarding NQTLs that may affect their MH/SUD benefits, or to
obtain documentation after an adverse benefit determination involving
MH/SUD benefits to support an appeal. The draft model form is an
information collection subject to the PRA. The model from and
instructions are available at https://www.dol.gov/agencies/ebsa.
II. Current Actions
This notice requests public comment on the draft model form
discussed above. The Department notes that an agency may not conduct or
sponsor, and a person is not required to respond to, an information
collection unless it displays a valid OMB control number. A summary of
the ICR and the current burden estimates follows:
Type of Review: Revised Collection.
Agency: DOL-EBSA.
Title: Notices under the Mental Health Parity and Addiction Equity
Act of 2008--Draft Model Non-Qualitative Treatment Limitations Form.
OMB Numbers: 1210-0138.
Affected Public: Private Sector--Not for profit organizations;
businesses or other for profits.
Total Respondents: 1,204,215 (combined with Treasury the total is
2,404,430).
Total Responses: 1,204,215 (combined with Treasury the total is
2,404,430).
Frequency of Response: On occasion.
Estimated Total Annual Burden Hours: 26,295 (combined with Treasury
the total is 52,590 hours.
Estimated Total Annual Burden Cost: $3,424,759 (combined with
Treasury the total is $6,849,519).
III. Desired Focus of Comments
The Department of Labor (Department) is particularly interested in
comments that:
Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
Evaluate the accuracy of the agency's estimate of the
burden of the proposed collection of information, including the
validity of the methodology and assumptions used;
Enhance the quality, utility, and clarity of the
information to be collected; and
Minimize the burden of the collection of information on
those who are to respond, including through the use of appropriate
automated, electronic, mechanical, or other technological collection
techniques or
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other forms of information technology, e.g., by permitting electronic
submissions of responses.
Comments submitted in response to this notice will be summarized
and/or included in the ICR for OMB approval of the revision of the
information collection; they will also become a matter of public
record.
Dated: June 9, 2017.
Joseph S. Piacentini,
Director, Office of Policy and Research, Employee Benefits Security
Administration.
[FR Doc. 2017-12773 Filed 6-19-17; 8:45 am]
BILLING CODE 4510-29-P