View Information Collection Request (ICR) Package
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View ICR - Agency Submission
OMB Control No:
0938-1022
ICR Reference No:
202508-0938-019
Status:
Received in OIRA
Previous ICR Reference No:
202506-0938-015
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
Date Submitted to OIRA:
08/26/2025
Requested
Previously Approved
Expiration Date
36 Months From Approved
01/31/2026
Responses
18,000
18,000
Time Burden (Hours)
1,351,632
2,283,878
Cost Burden (Dollars)
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. 108 - 173 5001(b)
Name of Law: Medicare Prescription Drug, Improvement and Modernization Act of 2003
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
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AV45
Final or interim final rulemaking
90 FR 36536
08/04/2025
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
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
ICR Summary of Burden
Total Request
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
18,000
18,000
0
0
0
0
Annual Time Burden (Hours)
1,351,632
2,283,878
0
-932,246
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
For the CY 2026 reporting period/FY 2028 payment determination, based on the policies in the FY 2026 IPPS/LTCH PPS final rule, we estimate a total burden of 1,351,632 hours and $73,667,099 (a decrease of 953,644 hours and $25,051,078 from our estimate in the FY 2025 IPPS/LTCH PPS final rule). This burden estimate also represents a decrease of 932,246 hours and $18,465,446 from the currently approved burden estimate of 2,283,878 hours and $92,132,545 for the CY 2025 reporting period/FY 2027 payment determination.
Annual Cost to Federal Government:
$10,582,965
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:
08/26/2025
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