View Information Collection Request (ICR) Package

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: 0938-1175	ICR Reference No: 201910-0938-003
Status: Historical Active	Previous ICR Reference No: 201905-0938-010
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program (CMS-10431)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/23/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/24/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2022	36 Months From Approved	01/31/2022
Responses	142,406	0	108,500
Time Burden (Hours)	75,779	0	75,782
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	142,406	108,500	0	33,906
Annual Time Burden (Hours)	75,779	75,782	-3	0
Annual Cost Burden (Dollars)	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: We are reducing a previously approved burden. We are finalizing the removal of one (1) web-based structural measure from the PCHQR Program, which will reduce the information collection burden on the PCHs. The change in the burden associated with these finalized policies is a reduction of approximately 3 hours (.25 fewer hours per year per PCH for the finalized removal of the web-based structural measure x 11 PCHs) across all 11 PCHs annually, and approximately $113 (.25 hours per PCH x 11 PCHs x $37.66 wage) annually across all 11 PCHs.

Annual Cost to Federal Government: $20,800

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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