Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)

ICR 201905-0938-008 · OMB 0938-1022 · Historical Inactive

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1022 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form CMS-10210 Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction	Modified	Available
CMS-10210 HIQR Supporting Statement A (5-14-2019).docx	Supporting Statement A	Uploaded 2019-05-15	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
204350	Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1022	ICR Reference No: 201905-0938-008
Status: Historical Inactive	Previous ICR Reference No: 201812-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10210
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: 10/07/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/15/2019
Terms of Clearance: 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	02/28/2022	36 Months From Approved	02/28/2022
Responses	17,600	0	17,600
Time Burden (Hours)	2,520,100	0	2,520,100
Cost Burden (Dollars)	0	0	0

Abstract: In the FY 2020 IPPS/LTCH PPS proposed rule, we are proposing to adopt the Hybrid Hospital-Wide Readmission Measure With Claims and Electronic Health Record Data (NQF #2879).

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-AT73	Proposed rulemaking	84 FR 19158	05/03/2019

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	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 , CAUTI Validation Template , CDI Validation Template , CLABSI Validation Template 1Q18-2Q18 , MRSA Validation Template , Validation Review for Reconsideration Request , VBP Appeal Request Form , HVBP CMS Independent Review Form , Validation Educational Review Form

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: We previously requested and received approval for total annual burden estimates under this OMB control number for the CY 2019 reporting period/FY 2021 payment determination of 2,520,100 hours as a result of policies finalized in the FY 2019 IPPS/LTCH PPS final rule. Additionally, we previously submitted total annual burden estimates under this OMB control number for the CY 2020 reporting period/FY 2022 payment determination of 1,612,710 hours â a total burden decrease of 907,390 hours â as a result of policies finalized in the FY 2019 IPPS/LTCH PPS final rule.

Annual Cost to Federal Government: $10,340,910

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? Uncollected

Agency Contact: Denise King 410 786-1013 [email protected]

Common Form ICR: No