Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010)

Information Collection Requirements for the Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1109 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10250 Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010) Form and Instruction
CMS-10250 CMS-10250.Notice of Participation CMS-10250.Notice of Participation.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10250	CMS-10250.Notice of Participation	CMS-10250.Notice of Participation.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	3,500	-3,495
Annual IC Time Burden (Hours)	20	14,000	-13,980
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.