Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10250 Hospital Outpatient Quality Program - Notice of Participation (CY 2016)	Form and Instruction	New	Available
Form CMS-10250 Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015)	Form and Instruction	New	Available
Form CMS-10250 Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014)	Form and Instruction	New	Repair queued
Form CMS-10250 Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2011)	Form and Instruction	Removed	Available
Form CMS-10250 Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010)	Form and Instruction	Removed	Available
CMS-10250.Supporting Statement Part B-2013.doc	Supporting Statement B	Uploaded 2013-12-20	Available
CMS-10250 Supporting Statement Part A-2013.doc	Supporting Statement A	Uploaded 2013-12-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
209862	Hospital Outpatient Quality Data Program - Data Validation (CY 2016)		New
209861	Hospital Outpatient Quality Program - Notice of Participation (CY 2016)	Form and Instruction	New
209860	Hospital Outpatient Quality Data Program - Data Abstration (CY 2016)		New
209859	Hospital Outpatient Quality Data Program - Data Validation (CY 2015)		New
209858	Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015)	Form and Instruction	New
209857	Hospital Outpatient Quality Data Program - Data Abstraction (CY 2015)		New
209856	Hospital Outpatient Quality Data Program - Data Validation (CY 2014)		New
209855	Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014)	Form and Instruction	New
209854	Hospital Outpatient Quality Data Program - Data Abstraction (CY 2014)		New
194748	Hospital Outpatient Quality Data Program (HOPQDRP) CY 2011 Data Abstraction		Removed
194747	Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2011)	Form and Instruction	Removed
191542	Hospital Outpatient Quality Data Program (HOPQDRP) - CY 2011 Data Validation	Instruction	Removed
191541	Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010)	Form and Instruction	Removed
191540	Hospital Outpatient Quality Data Program (HOPQDRP) - Abstracting Burden (CY 2009 and CY2010)		Removed

ICR Details

OMB Control No: 0938-1109	ICR Reference No: 201312-0938-017
Status: Historical Active	Previous ICR Reference No: 200912-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No: 21225
Title: Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/06/2014
	Date Received in OIRA: 12/23/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	02/28/2014
Responses	5,071,000	0	1,821,340
Time Burden (Hours)	2,906,749	0	1,802,186
Cost Burden (Dollars)	0	0	0

---

Abstract: This information is used by CMS to direct its contractor, including Quality Improvement Organizations (QIOs), to focus on particular areas of improvement, and to develop quality improvement initiatives. The information is made available to hospitals for their use in internal quality improvement initiatives. Most importantly, this information is available to Medicare beneficiaries, as well as to the general public, to provide hospital information to assist them in making decisions about their health care.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 3014 Name of Law: Affordable Care Act
   PL: Pub.L. 109 - 432 109(a) Name of Law: Quality reporting for hospital outpatient services and ambulatory surgical center services
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 43533	07/19/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 74825	12/10/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2011)	CMS-10250	CMS Notice of Participation
Hospital Outpatient Quality Data Program - Data Abstration (CY 2016)
Hospital Outpatient Quality Program - Notice of Participation (CY 2016)	CMS-10250	Notice of Participation
Hospital Outpatient Quality Data Program - Data Validation (CY 2016)
Hospital Outpatient Quality Data Program (HOPQDRP) - Abstracting Burden (CY 2009 and CY2010)
Hospital Outpatient Quality Data Program (HOPQDRP) - Notice of Participation (2010)	CMS-10250	CMS-10250.Notice of Participation
Hospital Outpatient Quality Data Program (HOPQDRP) - CY 2011 Data Validation
Hospital Outpatient Quality Data Program (HOPQDRP) CY 2011 Data Abstraction
Hospital Outpatient Quality Data Program - Data Abstraction (CY 2014)
Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014)	CMS-10250, CMS-10250, CMS-10250, CMS-10250	Notice of Participation ,   Request for Reconsideration Part 1 ,   Request for Reconsideration Part 2 ,   Extroadinary Circumstances
Hospital Outpatient Quality Data Program - Data Validation (CY 2014)
Hospital Outpatient Quality Data Program - Data Abstraction (CY 2015)
Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015)	CMS-10250	Notice of Participation
Hospital Outpatient Quality Data Program - Data Validation (CY 2015)

---

ICR Summary of Burden

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	5,071,000	1,821,340	0	3,249,660	0	0
Annual Time Burden (Hours)	2,906,749	1,802,186	0	1,104,563	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The program has increased the number of measures included in its data collection requirements. However, the newly proposed measures have data submission via a web-based tool, either directly to CMS or via the NHSN. These increases are in adherence to section 3013 of ACA which requires CMS to identify gaps where no quality measures exist and existing quality measures that need improvement, updating, or expansion.

---

Annual Cost to Federal Government: $11,500,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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

---

Common Form ICR:  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:

(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: 12/23/2013

---