Notice2026-04283

Agency Information Collection Activities; Comment on Affordable Care Act Internal Claims and Appeals and External Review Disclosures

Primary source

Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.

Published
March 4, 2026

Issuing agencies

Treasury DepartmentInternal Revenue Service

Abstract

In accordance with the Paperwork Reduction Act of 1995, the IRS is inviting comments on the information collection request outlined in this notice.

Full Text

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<title>Federal Register, Volume 91 Issue 42 (Wednesday, March 4, 2026)</title>
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[Federal Register Volume 91, Number 42 (Wednesday, March 4, 2026)]
[Notices]
[Page 10691]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-04283]


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DEPARTMENT OF THE TREASURY

Internal Revenue Service


Agency Information Collection Activities; Comment on Affordable 
Care Act Internal Claims and Appeals and External Review Disclosures

AGENCY: Internal Revenue Service (IRS), Treasury.

ACTION: Notice and request for comments.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995, the 
IRS is inviting comments on the information collection request outlined 
in this notice.

DATES: Written comments should be received on or before May 4, 2026 to 
be assured of consideration.

ADDRESSES: Direct all written comments to Andres Garcia, Internal 
Revenue Service, Room 6526, 1111 Constitution Avenue, Washington, DC 
20224, or by email to <a href="/cdn-cgi/l/email-protection#730301125d101c1e1e161d0700331a01005d141c05"><span class="__cf_email__" data-cfemail="8cfcfeeda2efe3e1e1e9e2f8ffcce5feffa2ebe3fa">[email&#160;protected]</span></a>. Include ``OMB Number: 1545-
2182'' in the subject line of the message.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of this collection should be directed to LaNita Van Dyke, at 
(202) 317-6009.

SUPPLEMENTARY INFORMATION: The IRS, in accordance with the Paperwork 
Reduction Act of 1995 (PRA) (44 U.S.C. 3506(c)(2)(A)), provides the 
general public and Federal agencies with an opportunity to comment on 
proposed, revised, and continuing collections of information. This 
helps the IRS assess the impact and minimize the burden of its 
information collection requirements. Comments submitted in response to 
this notice will be summarized and/or included in the request for OMB 
approval. All comments will become a matter of public record, and 
viewable on relevant websites. For this reason, please do not include 
in your comments information of a confidential nature, such as 
sensitive personal information. Comments are invited on: (a) Whether 
the collection of information is necessary for the proper performance 
of the functions of the agency, including whether the information shall 
have practical utility; (b) the accuracy of the agency's estimate of 
the burden of the collection of information; (c) ways to enhance the 
quality, utility, and clarity of the information to be collected; (d) 
ways to minimize the burden of the collection of information on 
respondents, including through the use of automated collection 
techniques or other forms of information technology; and (e) estimates 
of capital or start-up costs and costs of operation, maintenance, and 
purchase of services to provide information
    Title: Affordable Care Act Internal Claims and Appeals and External 
review Disclosures.
    OMB Number: 1545-2182.
    Regulation Number: T.D. 9494 and T.D. 9955.
    Abstract: This collection of information request includes the 
information collection and third- party notice and disclosure 
requirements that a plan must satisfy under final regulations 
implementing provisions of the Affordable Care Act pertaining to 
internal claims and appeals, and the external review process. The No 
Surprise Act extends the balance billing protections related to 
external reviews to grandfathered plans. The definitions of group 
health plan and health insurance issuer that are cited in section 110 
of the No Surprises Act include both grandfathered and non-
grandfathered plans and coverage. Accordingly, the practical effect of 
section 110 of the No Surprises Act is that grandfathered health plans 
must provide external review for adverse benefit determinations 
involving benefits subject to these surprise billing protections. 
Grandfathered and non-grandfathered plans must provide claimants, free 
of charge, any new or additional evidence considered, relied upon, or 
generated by the plan or issuer in connection with the claim, and the 
requirement to comply either with a State external review process or a 
Federal review process. The disclosure requirements of the Federal 
external review process require (1) a preliminary review by plans of 
requests for external appeals; (2) Independent Review Organizations 
(IROs) to notify claimants of eligibility and acceptance for external 
review; (3) the plan or issuer to provide IROs with documentation and 
other information considered in making adverse benefit determination; 
(4) the IRO to forward to the plan or issuer any information submitted 
by the claimant; (5) plans to notify the claimant and IRO if it 
reverses its decision; (6) the IRO to notify the claimant and plan of 
the result of the final external appeal; (7) the IRO to maintain 
records for six years.
    Current Actions: There is a change to the paperwork burden 
previously approved by OMB. Adjustments to the burden estimates result 
from updated estimates on the number of ERISA-covered plans and 
policyholders. These changes result in 713,149 fewer respondents, a 
decrease of 202,973 responses, a decline of the hour burden by 677 
hours,
    Total Estimated Number of Respondents: 1,294,150.
    Total Estimated Number of Responses: 187,601.
    Total Estimated Annual Burden Hours: 18,370 hours.

    Approved: March 2, 2026.
LaNita Van Dyke,
Tax Analyst.
[FR Doc. 2026-04283 Filed 3-3-26; 8:45 am]
BILLING CODE 4831-GV-P


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Indexed from Federal Register on March 4, 2026.

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