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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-1022
ICR Reference No:
201511-0938-001
Status:
Historical Active
Previous ICR Reference No:
201506-0938-004
Agency/Subagency:
HHS/CMS
Agency Tracking No:
21471
Title:
(CMS-10210) Hospital Reporting Initiative--Hospital Quality Measures
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
08/26/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/02/2015
Terms of Clearance:
Some elements of this collection began in advance of OMB approval. In light of that, CMS must submit this as a violation under the next Information Collection Budget. If this collection is submitted for approval again, CMS shall make clear what is included in the group "all other forms and structural measures".
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2019
36 Months From Approved
05/31/2018
Responses
17,600
0
17,600
Time Burden (Hours)
7,951,695
0
6,050,000
Cost Burden (Dollars)
0
0
0
Abstract:
In the FY 2016 IPPS Rule, we are finalizing seven new measures for the Hospital IQR Program measure set and removing nine measures from the Hospital IQR Program measure set, beginning with FY 2018. We are also proposing to require IPPS hospitals to report a minimum of 4 electronic clinical quality 4 measures. Additionally, we are updating our burden estimates due to the availability of more recent data. Using data on chart-abstracted measures from the 3rd quarter in 2013 through the 2nd quarter in 2014, we have revised our burden estimate assumptions to include updates to the number of records reported per measure set, as well as the time associated with data collection.
Authorizing Statute(s):
PL:
Pub.L. 108 - 173 5001(b)
Name of Law: Medicare Prescription Drug, Improvement and Modernization Act of 2003
PL:
Pub.L. 111 - 148 3001
Name of Law: Affordable Care Act
PL:
Pub.L. 109 - 171 5001(a)
Name of Law: Hospital Quality Improvement
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AS41
Final or interim final rulemaking
80 FR 49325
08/17/2015
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Quality Measures and Procedures for Hospital Reporting of Quality Data
CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210
Data Accuracy and Completeness Form
,
Hospital VPB Review and Corrections Form
,
Extraordinary Circumstances Form
,
Inpatient Withholding Data form
,
IQR Measure Exception Form
,
IQR Notice of Participation Form
,
IQR Reconsideration Request Form
,
CAUTI Validation Template
,
CDI Validation Template
,
CLABSI Validation Template
,
MRSA Validation Template
,
Validation Review for Reconsideration Request
,
VBP Appeal Request Form
ICR Summary of Burden
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
17,600
17,600
0
0
0
0
Annual Time Burden (Hours)
7,951,695
6,050,000
0
1,901,695
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This program has increased the number of measures included in its data collection requirements.
Annual Cost to Federal Government:
$10,050,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Denise King 410 786-1013 Denise.King@cms.hhs.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
11/02/2015
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