Information Collection Request

Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures)

ICR 200803-0938-005 · OMB 0938-1022 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10210 Notice of Participation Form and Instruction Modified Available
Form CMS-10210 HIPAA Compliance Form Modified Available
Form CMS-10210 Qnet Form Modified Available
Form CMS-10210 Oryx Form Modified Available
Form CMS-10210 Cart Summary Form Modified Available
Form CMS-10210 Notice of Participation Form and Instruction Modified Available
Form CMS-10210 HIPAA Compliance Form Modified Available
Form CMS-10210 Qnet Form Modified Available
Form CMS-10210 Oryx Form Modified Available
Form CMS-10210 Cart Summary Form Modified Available
CMS-10210.Draft Supporting Statement-Part B final.CLEAN.doc Supporting Statement B Uploaded 2008-03-04 Available
0938-1022.Justification for Emergency Processing and Approval.doc Supplementary Document Uploaded 2008-03-04 Available
CMS-10210.Emergency FRN (73FR4868)1-28-08.pdf Supplementary Document Uploaded 2008-03-04 Available
CMS-10210 Draft Supporting Statement-Part A final.CLEAN.doc Supporting Statement A Uploaded 2008-03-04 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
178678 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form and Instruction ModifiedNotice of Participation
178678 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedHIPAA Compliance
178678 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedQnet
178678 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedOryx
178678 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedCart Summary
178677 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form and Instruction ModifiedNotice of Participation
178677 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedHIPAA Compliance
178677 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedQnet
178677 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedOryx
178677 Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) Form ModifiedCart Summary

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2011 6 Months From Approved 12/31/2008
874,976 0 874,976
806,250 0 587,486
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210 ,   ,   ,   ,  
Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2008 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures) CMS-10210, CMS-10210, CMS-10210, CMS-10210, CMS-10210 ,   ,   ,   ,  

table that charts list of burden
  Total Approved 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 874,976 874,976 0 0 0 0
Annual Time Burden (Hours) 806,250 587,486 0 0 218,764 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No