Crosswalk (Appendix B)

PCHQR PRA_Appendix B July_24_2014.docx

PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program

Crosswalk (Appendix B)

OMB: 0938-1175

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Appendix B
Note: * There is not a need to add contractor’s information to the web applications.

+ Submitted under the Hospital IQR program. We are using a standard ECE form that

would apply across all quality reporting programs.

Table A. Summary of PCHQR Information Collection Forms

Forms Submitted with the 2015 IPPS/LTCH PPS Final Rule PRA Package

Note

Program/

Procedural Requirements

Measures Exception Paper-Based*

Updated to reflect contractor’s information

NOP Paper-Based*

DACA Paper-Based*

Extraordinary Circumstances Exception (ECE) Paper-Based and Web application+

Newly proposed program and measure requirements

Measure Requirements

EBRT Measure Data Collection Paper-Based and Web Application

EBRT Measure Sampling Paper Based and Web Application

SCIP Data Collection Paper-Based

Updated to reflect contractor’s information

Oncology Care Measures Data Collection Paper-Based

SCIP Measures Sampling Paper-Based and Web Application

Newly proposed program requirements

Oncology Care Measures Sampling Paper-Based and Web Application



Table B. Frequency of Data Collection


Form

Frequency

Program/

Procedural Requirements

Measures Exception

Annually

NOP

DACA

Extraordinary Circumstances Exception (ECE)

Dependent on the situation

Measure Requirements

OCM

Annually

EBRT

Cancer Specific Treatment*

CLABSI and CAUTI*

SCIP

Quarterly

SSI

HCAHPS

Note: *No forms have been submitted for these measures because CMS leverage with

the ACoS and CDC in obtaining data files from these entities.





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AuthorFowler, Suzanna
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