View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0938-1314
ICR Reference No:
201611-0938-002
Status:
Historical Active
Previous ICR Reference No:
201606-0938-001
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
(CMS-10621) Merit-based Incentive Payment System
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 with change
Conclusion Date:
03/31/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/01/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2020
36 Months From Approved
Responses
1,689,076
0
0
Time Burden (Hours)
10,947,453
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Section 1848(q) of the Social Security Act, as amended by section 101 of the Medicare Access and CHIP Reauthorization Act of 2015, authorizes the establishment of a Merit-based Incentive Payment System(MIPS) for eligible clinicians. Beginning in CY 2017, eligible clinicians will be required to collect and submit data on four performance categories to CMS (quality, resource use, advancing care information, and clinical practice improvement activity). This program replaces and consolidates portions of the PQRS, Value-based Modifier, and Medicare EHR Medicare Incentive Program.
Authorizing Statute(s):
US Code:
42 USC 1395w-4
Name of Law: Medicare Access and CHIP Reauthorization Act of 2014
Citations for New Statutory Requirements:
US Code: 42 USC 1395w-4 Name of Law: Medicare Access and CHIP Reauthorization Act of 2014
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AS69
Final or interim final rulemaking
81 FR 77008
11/04/2016
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
10
IC Title
Form No.
Form Name
$414.1430 (Partial Qualifying APM Participant (QP) election)
414.1400 (Quality Performance Category) CAPHs for MIPS
§414.1330 and §414.1335 CMS Web Interface Submission Mechanism
CMS-10621
List of Quality Performance Category Measures
§414.1330 and §414.1335 Claims Submission Mechanism
CMS-10621
List of Quality Performance Category Measures
§414.1330 and §414.1335 EHR Submission Mechanism
CMS-10621
List of Quality Performance Category Measures
§414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism
CMS-10621
List of Quality Performance Category Measures
§414.1360 (Improvement Activities)
CMS-10621
Improvement Activities Inventory
§414.1375 (Advancing Care Information Performance Category)
CMS-10621
List of Advancing Care Information Performance Category
§414.1390 (Data Validation and Auditing)
CMS-10621, CMS-10621
§414.1400 QCDR and qualified registry self nomination
CMS-10621
QCDR Self-nomination 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
1,689,076
0
0
1,689,076
0
0
Annual Time Burden (Hours)
10,947,453
0
0
10,947,453
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:
There is a change in the burden because are changes in the number of respondents.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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:
11/01/2016
An official website of the United States government
The .gov means it's official.
The site is secure.
