View Information Collection Request (ICR) Package
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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:
202406-0938-006
Status:
Historical Inactive
Previous ICR Reference No:
202309-0938-013
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:
Comment filed on proposed rule and continue
Conclusion Date:
07/22/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/17/2024
Terms of Clearance:
In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2026
36 Months From Approved
01/31/2026
Responses
18,000
0
18,000
Time Burden (Hours)
2,286,977
0
2,286,977
Cost Burden (Dollars)
0
0
0
Abstract:
This request covers data collection requirements for the FY 2027 payment determination and subsequent years. This revised information collection request includes burden for the proposed adoption of the Age Friendly Hospital measure, the proposed increase in the number of eCQMs hospitals would be required to report, and the removal of the Measure Exception Form for NHSN HAI Measures from this information collection in addition to updated data and wage rates impacting previously approved burden calculations.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 3001
Name of Law: Affordable Care Act
PL:
Pub.L. 108 - 173 5001(b)
Name of Law: Medicare Prescription Drug, Improvement and Modernization Act of 2003
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-AV34
Proposed rulemaking
89 FR 35934
05/02/2024
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, 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 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
,
Maternal Morbidity Structural Measure
,
Population and Sampling
,
Hospital Inpatient Quality Reporting Program Denominator Declaration
,
THA/TKA Patient-Reported Outcome-based Performance Measure
,
Social Drivers of Health Structural Measures
,
Hospital Commitment to Health Equity
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:
This burden estimate also represents a decrease of 3,099 hours and an increase of $11,856,849 from the currently approved burden estimate of 2,286,977 hours and $80,275,696 for the CY 2023 reporting period/FY 2025 payment determination.
Annual Cost to Federal Government:
$10,571,400
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:
06/17/2024
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