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:
0938-1022
ICR Reference No:
202109-0938-012
Status:
Historical Active
Previous ICR Reference No:
202108-0938-001
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCSQ
Title:
Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)
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:
02/07/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/13/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2022
36 Months From Approved
12/31/2022
Responses
17,600
0
17,600
Time Burden (Hours)
1,572,810
0
1,572,443
Cost Burden (Dollars)
0
0
0
Abstract:
In the FY 2022 IPPS/LTCH PPS final rule, we are finalizing to adopt the Maternal Morbidity Structural Measure beginning with a shortened reporting period from October 1 through December 31, 2021 (affecting the FY 2023 payment determination), followed by annual reporting periods for subsequent years. The shortened data submission period for the Maternal Morbidity Structural Measure would run from October 1 through December 31, 2021, followed by annual reporting periods for subsequent years. We are also finalizing the adoption of the Hybrid Hospital-Wide All-Risk Standardized Mortality measure with Claims and Electronic Health Record Data (Hybrid HWM measure) beginning with a one-year voluntary reporting period (July 1, 2022 through June 30, 2023), followed by mandatory reporting beginning with the July 1, 2023 through June 30, 2024 reporting period/FY 2026 payment determination. In this PRA Package, we are requesting approval for an increase in the total burden we expect to be experienced by approximately 4,400 participating hospitals (3,300 IPPS hospitals and 1,100 non-IPPS hospitals), beginning with the FY 2023 payment determination.
Authorizing Statute(s):
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
PL:
Pub.L. 108 - 173 5001(b)
Name of Law: Medicare Prescription Drug, Improvement and Modernization Act of 2003
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AU44
Final or interim final rulemaking
86 FR 44774
09/13/2021
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
Data Accuracy and Completeness Form
,
Hospital VPB Review and Corrections Form
,
Extraordinary Circumstances Form
,
Hospital Compare Request Form for Withholding/Footnoting Data for Public Reporting
,
IQR Measure Exception Form
,
IQR Notice of Participation Form
,
IQR Reconsideration Request Form
,
Validation Review for Reconsideration Request
,
VBP Appeal Request Form
,
HVBP CMS Independent Review Form
,
Validation Educational Review 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)
1,572,810
1,572,443
0
367
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:
We previously requested and received approval for total annual burden estimates under this OMB control number for the CY 2021 reporting period/FY 2023 payment determination of 1,572,443 hours at a total cost of approximately $64.5 million (accounting for updated wage rates) as a result of policies finalized in the FY 2021 IPPS/LTCH PPS final rule. The updated wage rate from $38.80/hour to $41.00/hour results in a total increase of approximately $3.5 million. The finalized policy in the FY 2022 IPPS/LTCH PPS final rule to adopt the Maternal Morbidity Structural Measure for the FY 2023 payment determination results in an increase of 367 hours and $15,033 for the CY 2021 reporting period/FY 2023 payment determination. The finalized policy to adopt the Hybrid HWM measure beginning in the CY 2022 reporting period/FY 2024 payment determination results in an increase of 2,933 hours and $120,267.
Annual Cost to Federal Government:
$10,361,070
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?
No
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:
09/13/2021
An official website of the United States government
The .gov means it's official.
The site is secure.
