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

Forms and Documents

Document Name	Status
Form CMS-10250 Hospital Outpatient Quality Program - Notice of Participation (CY 2016) Form and Instruction	Unchanged
Form CMS-10250 Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015) Form and Instruction	Unchanged
Form CMS-10250 Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014) Form and Instruction	Unchanged
CMS-10250.Supporting Statement Part B-2013.doc Supporting Statement B	2014-12-03
CMS-10250 Supporting Statement Part A-2013 (UPDATED v2 07_25_2014).doc Supporting Statement A	2014-12-03

IC Document Collections

IC ID	Document Title	Status
213183	Hospital Outpatient Quality Data Program -Web based OP-31 (CY 2017)	Unchanged
213179	Hospital Outpatient Quality Data Program - Administrative (CY 2017)	Unchanged
213175	Hospital Outpatiennt Quality Data Program - Data Validation (CY 2017)	Unchanged
213174	Hospital Outpatient Quality Data Program - Notice of Participation Web based (CY 2017)	Unchanged
213170	Hospital Outpatient Quality Data Program -- Data Abstration (CY 2017)	Unchanged
209862	Hospital Outpatient Quality Data Program - Data Validation (CY 2016)	Unchanged
209861	Hospital Outpatient Quality Program - Notice of Participation (CY 2016) Form and Instruction	Unchanged
209860	Hospital Outpatient Quality Data Program - Data Abstration (CY 2016)	Unchanged
209859	Hospital Outpatient Quality Data Program - Data Validation (CY 2015)	Unchanged
209858	Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015) Form and Instruction	Unchanged
209857	Hospital Outpatient Quality Data Program - Data Abstraction (CY 2015)	Unchanged
209856	Hospital Outpatient Quality Data Program - Data Validation (CY 2014)	Unchanged
209855	Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014) Form and Instruction	Unchanged
209854	Hospital Outpatient Quality Data Program - Data Abstraction (CY 2014)	Unchanged

ICR Details

OMB Control No: 0938-1109	ICR Reference No: 201412-0938-001
Status: Historical Active	Previous ICR Reference No: 201409-0938-012
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: 01/16/2015
	Date Received in OIRA: 12/03/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	24 Months From Approved	02/28/2017
Responses	5,115,060	0	5,071,000
Time Burden (Hours)	6,060,452	0	2,906,749
Cost Burden (Dollars)	0	0	0

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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.

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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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS15	Final or interim final rulemaking	79 FR 66770	11/10/2014

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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: 14

IC Title	Form No.	Form Name
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)
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 -- Data Abstration (CY 2017)
Hospital Outpatient Quality Data Program - Administrative (CY 2017)
Hospital Outpatient Quality Data Program - Notice of Participation Web based (CY 2017)
Hospital Outpatiennt Quality Data Program - Data Validation (CY 2017)
Hospital Outpatient Quality Data Program -Web based OP-31 (CY 2017)

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ICR Summary 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	5,115,060	5,071,000	0	44,060	0	0
Annual Time Burden (Hours)	6,060,452	2,906,749	0	3,153,703	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: No

Burden Reduction Due to:

Short Statement: The program has decreased the number of measures included in its data collection requirements. However, the program has also increased the number of cases reported for chart-abstracted measures and has added administrative burden estimates. Therefore, there is a net increase in burden. .

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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]? No

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: 12/03/2014

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