View Information Collection Request (ICR) Package
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View Information Collection (IC) List
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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:
0938-1171
ICR Reference No:
201209-0938-003
Status:
Historical Active
Previous ICR Reference No:
201205-0938-005
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Inpatient Psychiatric Facility Quality Reporting Program
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/20/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/14/2012
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2015
36 Months From Approved
Responses
471,811
0
0
Time Burden (Hours)
1,415,433
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Section 10322 of the Affordable Care Act authorizes the establishment of a new quality reporting program for Inpatient Psychiatric Facilities (IPFs). Beginning in FY 2014 and subsequent fiscal years, the quality measures IPFs are required to collect and submit six (6) quality measures to CMS. IPFs failing to submit the quality measures will receive a 2% reduction. In an effort to minimize burden and maximize efficiency, CMS has leverage existing system within CMS to collect aggregated and calculated measure rates from the IPFs, in a form, manner and time as specified by CMS, via a secure portal known as the QualityNet Web site beginning of October 1, 2012 for FY2014 payment determination year. CMS is proposing to implement some procedural requirements to align with current quality reporting programs. These procedural requirements would involve submitting necessary forms to comply with the IPFQR Program and aligns with current CMS reporting requirements for other quality programs. The aforementioned forms are the Notice of Participation From, Decline to Participate Form, Participation Withdrawal Form, Reconsideration Request Form, Disaster Waiver form and the IPFQR notification form letter.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 10322
Name of Law: Affordable Care Act
Citations for New Statutory Requirements:
PL: Pub.L. 111 - 148 10322 Name of Law: Affordable Care Act
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AR12
Final or interim final rulemaking
77 FR 53258
08/31/2012
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
Inpatient Psychiatric Facility Quality Reporting Program
CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432
Data Collection
,
Notice of Participation
,
Data Accuracy and Completeness
,
Decline to Participate
,
Withdrawal
,
Reconsideration Request
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
471,811
0
471,811
0
0
0
Annual Time Burden (Hours)
1,415,433
0
1,415,433
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Between the draft rule and the final rule, there have been minor editorial changes to the forms. The burden has not changed.
Annual Cost to Federal Government:
$41,600
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:
William Parham 4107864669
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:
09/14/2012
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