PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10431 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Available
CMS PCH Crosswalk.March_14_2013.pdf	Supplementary Document	Uploaded 2013-05-15	Available
CMS-10431 Supporting Statement Part A.pdf	Supporting Statement A	Uploaded 2013-05-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1175	ICR Reference No: 201305-0938-013
Status: Historical Inactive	Previous ICR Reference No: 201209-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No: 19603
Title: PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program
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: 01/15/2014
	Date Received in OIRA: 05/21/2013
Terms of Clearance: Comment Filed

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	36 Months From Approved	12/31/2015
Responses	27,273	0	27,273
Time Burden (Hours)	68,182	0	68,182
Cost Burden (Dollars)	0	0	0

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Abstract: Section 3005 of the Affordable Care Act authorizes the establishment of a quality reporting program for PPS-exempt cancer hospitals (PCHs). Beginning in FY 2015 and subsequent fiscal years, the quality measures PPS-exempt cancer hospitals are required to collect and submit 19 quality measures to CMS (5 of these were previously reported under this program, and 14 are new). In an effort to minimize burden and maximize efficiency, CMS has leveraged existing systems to collect aggregated and calculated measure rates beginning with FY2014 program year. CMS is proposing to implement some procedural requirements to align with current quality reporting programs. These procedural requirements would involve submitting necessary forms to comply with the PCHQR Program and aligns with current CMS reporting requirements for other quality programs. The aforementioned forms are the Notice of Participation (NOP), Data Accuracy and Completeness Acknowledgement (DACA), Data Collection, Waiver, and QualityNet secure web registration forms.

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Authorizing Statute(s): PL: Pub.L. 111 - 48 3005 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AR12	Proposed rulemaking	78 FR 27485	05/10/2013

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431	Oncology Care Measures Online Data Entry Tool ,   Surgical Care Improvement Online Data Entry Tool ,   Surgical Care Improvement Paper Submission ,   Oncology Care Paper Submission ,   Extroadinary Circumstances/Disaster Extension or Waiver Request Form ,   Extroadinary Circumstance Paper Form ,   Measure Exception Form ,   Notice of Participation Paper Form ,   Data Accuracy and Completeness Agreement ,   Data Accuracy and Completeness Agreement Screen Shot ,   Notice of Participation Screenshot

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is Year 2 data submission to comply with statutory requirement by implementing a quality reporting program for the PPS-exempt cancer hospital (PCH). During the Measures Application Partnership (MAP) assessment of measures for the PCHQR program, several gap areas were identified within this program. This program expansion uses existing quality measures to fill these gaps identified in the MAP assessment, and seeks to improve quality information about the entire patient experience, and care provided.

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Annual Cost to Federal Government: $83,200

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/21/2013

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