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 201210-0938-002 · OMB 0938-1022 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10210 Extroadinary Circumstance Online Form and Instruction New Available
Form CMS-10210 Reconsideration Request Paper Form and Instruction New Available
Form CMS-10210 Reconsideration Request Online Form and Instruction New Repair queued
Form CMS-10210 HAI Exception Paper Form and Instruction New Available
Form CMS-10210 HAI Exception Online Form and Instruction New Available
Form CMS-10210 Notice of Participation Form and Instruction New Available
Form CMS-10210 Data Accuracy and Completeness Form and Instruction New Available
Form CMS-10210 Decline to Participate Form and Instruction New Available
Form CMS-10210 Reconsideration Request Part 2 Form and Instruction New Available
Form CMS-10210 Extroadinary Circumstance Paper Form and Instruction New Available
Form CMS-10210 Hospital Data Validation Form and Instruction New Available
Form CMS-10210 Notice of Participation Form and Instruction Removed Available
Form CMS-10210 HIPAA Compliance Form Removed Available
Form CMS-10210 Qnet Form Removed Available
Form CMS-10210 Oryx Form Removed Available
Form CMS-10210 Cart Summary Form Removed Available
Form CMS-10210 Notice of Participation Form and Instruction Removed Available
Form CMS-10210 HIPAA Compliance Form Removed Available
Form CMS-10210 Qnet Form Removed Available
Form CMS-10210 Oryx Form Removed Available
Form CMS-10210 Cart Summary Form Removed Available
CMS 10210 Supporting Statement A.docx Supporting Statement A Uploaded 2012-10-01 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewExtroadinary Circumstance Online
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewReconsideration Request Paper
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewReconsideration Request Online
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewHAI Exception Paper
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewHAI Exception Online
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewNotice of Participation
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewData Accuracy and Completeness
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewDecline to Participate
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewReconsideration Request Part 2
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewExtroadinary Circumstance Paper
204350 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction NewHospital Data Validation
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 RemovedNotice 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 RemovedHIPAA 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 RemovedQnet
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 RemovedOryx
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 RemovedCart 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 RemovedNotice 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 RemovedHIPAA 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 RemovedQnet
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 RemovedOryx
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 RemovedCart Summary

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2016 36 Months From Approved
17,600 0 0
6,750,000 0 0
0 0 0





Reginfo record details
1
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 ,   ,   ,   ,  
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 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  

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 17,600 0 0 17,600 0 0
Annual Time Burden (Hours) 6,750,000 0 0 6,531,236 218,764 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No