Hospice Voluntary Quality Data Reporting Program

ICR 201112-0938-011

OMB: 0938-1153

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2012-01-03
IC Document Collections
ICR Details
0938-1153 201112-0938-011
Historical Active 201111-0938-013
HHS/CMS
Hospice Voluntary Quality Data Reporting Program
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/03/2012
Retrieve Notice of Action (NOA) 12/30/2011
  Inventory as of this Action Requested Previously Approved
01/31/2014 36 Months From Approved
1,766 0 0
442 0 0
0 0 0

Section 1814(i)(5) of the Social Security Act (Act)added by section 3004 of Patient Protection and Affordable Care Act, Pub. L. 111 148, enacted on March 23, 2010 (Affordable Care Act), authorizes the Secretary to establish a quality reporting program for hospices. Section 1814(i)(5)(A)(i) of the Act requires that the Secretary, beginning with FY 2014, reduce the market basket update by 2 percentage points for any hospice that does not comply with the quality data submission requirements with respect to that fiscal year. To meet the quality reporting requirements for hospices, as set forth in the proposed Hospice Wage Index for Fiscal Year 2012 rule, we propose that there shall be a voluntary hospice quality reporting cycle which will consist of data collection cycle beginning on October 1, 2011 and continuing through December 31, 2011. This data shall be reported to CMS by no later than January 31, 2012. There shall be a mandatory hospice quality reporting cycle which will consist of data collected from October 1, 2012 through December 31, 2012. This data shall be reported to CMS by no later than April 1, 2013. Thereafter, it is proposed that all subsequent hospice quality reporting cycles will be based on the calendar-year basis(that is, January 1, 2013 through December 31, 2013 for determination of the Hospice market basket increase factor for each Hospice in FY 2015, etc.). We are requesting an initial approval of a data collection instrument entitled "Quality Data Submission Form" that hospice providers will use to submit quality measures data to CMS during the proposed voluntary reporting period of 10/01/2011 through 12/31/2011. This form shall be used by hospices to report quality data pertaining to one structural measure, which is entitled: Participation in a Quality Assessment and Performance Improvement (QAPI) Program that Includes at Least Three Quality Indicators Related to Patient Care.

PL: Pub.L. 111 - 148 3004 Name of Law: Patient Protection and Affordable Care Act
  
PL: Pub.L. 111 - 148 3004 Name of Law: Patient Protection and Affordable Care Act

0938-AQ31 Final or interim final rulemaking 76 FR 47302 09/04/2011

  76 FR 54776 09/02/2011
76 FR 73649 11/29/2011
No

1
IC Title Form No. Form Name
Hospice Voluntary Quality Data Reporting Form CMS-10390 User Guide for Hospice Quality Reporting Data Entry Site

  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 1,766 0 1,766 0 0 0
Annual Time Burden (Hours) 442 0 442 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new collection.

$123,300
No
No
Yes
No
No
Uncollected
William Parham 4107864669

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/30/2011


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