Information Collection Request

Medical Necessity and Contract Amendments Under Mental Health Parity (CMS-10556)

ICR 202211-0938-009 · OMB 0938-1280 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1280 can be found here:

Forms and Documents

Document Name	Status
CMS-10556 - Supporting Statement A (2022 version 7).docx Supporting Statement A	2022-11-22

IC Document Collections

IC ID	Document Title	Status
220885	State Analysis and Transparency Responsibilities (sec. 438.920)	Modified
220884	Submitting Requests for Medical Necessity Disclosures (Potential Participants, Beneficiaries, and Contracting Providers)	Modified
216060	State Contract Requirements (§ 438.3(n))	Modified
216059	Availability of Information and the Criteria for Medical Necessity Determinations (Regulated Entities)	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1280
Type of Information Collection	Extension without change of a currently approved collection
Previous ICR Reference No	201909-0938-005
Agency Tracking No	CMCS
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31