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OMB Control No: 0938-0426	ICR Reference No: 202511-0938-016
Status: Received in OIRA	Previous ICR Reference No: 202112-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: HSQ-110 Acquisition, Protection, and Disclosure of Quality Improvement Organization (QIO) Information and Supporting Regulations (CMS-R-70)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 11/26/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	53,850	0
Time Burden (Hours)	521,599	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	53,850	0	53,850
Annual Time Burden (Hours)	521,599	117,391	404,208
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 burden hours changed, and the cost increased due to wage rates being updated. The burden hours increased from 404,208 to 521,599. The costs increased from $16 million to $23 million.

Annual Cost to Federal Government: $62,066

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: Denise King 410 786-1013 Denise.King@cms.hhs.gov