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
PCHQR PRA_Appendix A 04_07_2015 revised (508 ready ef).docx	Supplementary Document	Uploaded 2015-05-11	Available
CMS-10431_Supporting Statement A PRA _PCHQR 04_07_2015_(508 ready ef).docx	Supporting Statement A	Uploaded 2015-05-11	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: 201505-0938-005
Status: Historical Inactive	Previous ICR Reference No: 201401-0938-010
Agency/Subagency: HHS/CMS	Agency Tracking No: 21324
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: 06/22/2015
	Date Received in OIRA: 05/11/2015
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	12/31/2017	11/30/2016
Responses	413,556	0	413,556
Time Burden (Hours)	206,891	0	206,891
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). This is an update to the previously approved PCHQR Program PRA submission. Based on the FY2016 IPPS/LTCH rule we are removing the six Surgical Care Improvement Program (SCIP) measures and adding three CDC NHSN measures.

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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-AS41	Proposed rulemaking	80 FR 24323	04/30/2015

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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 Paper Submission ,   SCIP Measures Paper Submission ,   EBRT Pop Sample Application ,   EBRT Paper based ,   EBRT Pop Sample paper based ,   EBRT web application ,   Oncology Care Measures Pop Sample application ,   OCM Pop Sample paper based ,   SCIP Pop Sample paper based ,   SCIP Pop Sample Application ,   Measure Exception Form

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden decreased because six surgical care improvement project (SCIP) measures were removed. The total change in burden based on the changes proposed in this year's rule are to decrease responses by 12,925 responses per year, which equates to a decrease of 6466.17 hours per year

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Annual Cost to Federal Government: $20,800

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: 05/11/2015

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