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OMB Control No: 0906-0022	ICR Reference No: 202511-0906-001
Status: Received in OIRA	Previous ICR Reference No: 202209-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: HIV Quality Measures Performance Measure Module (HIVQM Module)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 11/25/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	8,252	0
Time Burden (Hours)	1,925	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	8,252	0	8,252
Annual Time Burden (Hours)	1,925	137	1,788
Annual Cost Burden (Dollars)	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: The FRN was pending approval due to the lapse in appropriations, therefore, we do not believe this is a PRA violation. The average burden per response changed from 1 hour in the 60-day FRN to 0.233 hours (14 minutes) for the 30-day FRN. This occurred because a regular pilot test of the HIVQM Module was completed between the publication of the 60-day FRN and the drafting of the 30-day FRN.  The 30-day FRN reflects the results of the pilot test.

Annual Cost to Federal Government: $1,841,038

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]? No

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: Laura Cooper 301 443-2126 lcooper@hrsa.gov