CMS-10390 - Hospice Item Set Supporting Statement - Part A

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES

OFFICE OF MANAGEMENT AND BUDGET
PAPERWORK REDUCTION ACT
CLEARANCE PACKAGE

SUPPORTING STATEMENT-PART A
HOSPICE ITEM SET V2.00.0
FOR THE COLLECTION OF DATA
PERTAINING TO THE
HOSPICE QUALITY REPORTING PROGRAM

SUPPORTING STATEMENT-PART A
HOSPICE ITEM SET V2.00.0
FOR THE COLLECTION OF DATA
PERTAINING TO THE
HOSPICE QUALITY REPORTING PROGRAM

Table of Contents
A.

Background .............................................................................................................................1

B.

Justification .............................................................................................................................2
1.
Circumstances Making the Collection of Information Necessary .................................2
2.
Purpose and Use of the Information Collection.............................................................3
3.
Use of Improved Information Technology and Burden Reduction ...............................3
4.
Efforts to Identify Duplication and Use of Similar Information....................................4
5.
Impact on Small Businesses or Other Small Entities.....................................................4
6.
Consequences of Collecting the Information Less Frequently ......................................4
7.
Special Circumstances Relating to the Guidelines of 5 CFR 1320.5 ............................4
8.
Comments in Response to the Federal Register Notice and Efforts to Consult
Outside the Agency ........................................................................................................4
9.
Explanation of Any Payment or Gift to Respondents....................................................4
10. Assurance of Confidentiality Provided to Respondents ................................................5
11. Justification for Sensitive Questions ..............................................................................5
12. Estimates of Annualized Burden Hours and Costs ........................................................5
13. Estimates of Other Total Annual Cost Burden to Respondents and Record
Keepers ..........................................................................................................................8
14. Annualized Cost to the Federal Government .................................................................8
15. Explanation for Program Changes or Adjustments .......................................................9
16. Plans for Tabulation and Publication and Project Time Schedule ...............................10
17. Reason(s) Display of OMB Expiration Date is Inappropriate .....................................10
18. Exceptions to Certification for Paperwork Reduction Act Submissions .....................10

Exhibit A
FY 2017 Hospice PRA Burden Estimate Calculation Worksheet
Exhibit B
FY 2014 Hospice PRA Burden Estimate Calculation Worksheet

i

Supporting Statement A
For Paperwork Reduction Act Submissions

Hospice Item Set For the Collection of Data Pertaining to the
Hospice Quality Reporting Program
(OMB Control Number – 0938-1153)
A. Background
On July 1, 2014, hospices began using a newly created data collection instrument, titled the “Hospice
Item Set” (HIS) v1.00.0. This item set is used for the collection of quality measure data related to the
Hospice Quality Reporting Program (HQRP). This Paperwork Reduction Act submission is for HIS
v2.00.0. The HIS v2.00.0 will include the items as the HIS v1.00.0, with the addition of several new items
for use in new measures, measure refinement, patient record matching, and future public reporting.
The HIS v2.00.0 consists of data elements that are designed to collect standardized, patient-level data for
the following domains of care:
• Pain
• Respiratory Status
• Medications
• Patient Preferences
• Beliefs & Values
• Visits when Death is Imminent
The HIS was developed specifically for use by hospices and contains data elements that can be used by
CMS to collect patient-level data to calculate six National Quality Forum (NQF) endorsed quality
measures, a modification of one NQF-endorsed measure, and two measures that are not yet NQF
endorsed under the HQRP (see Table 1).
Table 1. NQF-Endorsed Measures Corresponding to the Hospice Item Set
NQF Number
Measure Name
NQF #1634
Hospice and Palliative Care – Pain Screening
NQF #1637
Hospice and Palliative Care – Pain Assessment
NQF #1639
Hospice and Palliative Care – Dyspnea Screening
NQF #1638
Hospice and Palliative Care – Dyspnea Treatment
NQF #1617
Patients Treated With an Opioid who are Given a Bowel Regimen
NQF #1641
Hospice and Palliative Care – Treatment Preferences
NQF #1647 (modified)
Beliefs/values addressed
(not yet NQF endorsed) Hospice and Palliative Care Composite Process Measure – Comprehensive
Assessment at Admission
(not yet NQF endorsed) Visits when Death is Imminent

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B. Justification
1. Circumstances Making the Collection of Information Necessary
Section 3004(c) of the Affordable Care Act (ACA), which added section 1814(i)(5)(A)(i) to the Social
Security Act (The Act), authorized the establishment of a new quality reporting program for hospices. 1
Section 3004(c)(5)(C) of the ACA requires that hospices must submit quality data in a form, manner, and
time specified by the Secretary. Section 3004(c)(5)(A)(i) further provides that, beginning with FY 2014,
the Secretary shall apply a reduction in the amount of two (2) percentage points to the market basket
percentage increase for any hospice that fails to submit data to the Secretary in accordance with
requirements established by the Secretary for that fiscal year.
CMS established the Hospice Quality Reporting Program (HQRP) in the FY 2012 Hospice Wage Index
Final Rule (76 FR 47318 through 47324, and 47325 through 47326). 2 In this rule, CMS set forth the
initial framework for the HQRP and established that the first reporting period would take place from
October 1, 2012 through December 31, 2012. During the first reporting period, hospices were required to
gather data pertaining to two quality measures: (1) a structural measure titled “Participation in a Quality
Assessment and Performance Improvement (QAPI) Program that Includes at Least Three Quality
Indicators Related to Patient Care” and; (2) the National Quality Forum (NQF)-endorsed #0209 pain
measure. Hospice providers were then required to report their data between 01/01/2012 and 04/01/2012.
In the CY 2013 HH PPS final rule (77 FR 67132 through 67136), 3 CMS retained the two measures that
had previously been adopted in the FY 2012 rule. Hospices continued to collect data for these measures
until December 31, 2013. CMS retired these two measures in the FY 2014 final rule (78 FR 48256
through 48257).
In the FY 2014 Hospice Wage Index final rule (78 FR 48257), 4 CMS finalized the specific collection of
data items that support six NQF endorsed measures and one modified measure for hospice. Data for the 7
measures is collected via the HIS V1.00.0.
In the FY 2017 Hospice Wage Index Proposed Rule, CMS retains 7 measures that were previously
adopted in the FY 2014 rule and proposes two new quality measures. The Hospice and Palliative Care
Composite Process Measure – Comprehensive Assessment at Admission is a composite measure created
from components which are currently adopted HQRP measures and calculated using existing items on the
HIS V1.00.0; thus no new data collection is required. The Hospice Visits when Death is Imminent
Measure Pair would use data collected via 4 new HIS items. For one existing measure, NQF #1637
measure refinement requires the implementation of one new HIS item. Public reporting of hospice quality

1 Patient Protection and Affordable Care Act. Pub. L. 111-148. Stat. 124-119. 23 March 2010. Web.
http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf.
2 Medicare Program; Hospice Wage Index for Fiscal Year 2012; Final Rule, Federal Register/Vol. 76, No. 150
August 4, 2011. http://www.gpo.gov/fdsys/pkg/FR-2011-08-04/pdf/2011-19488.pdf
3 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice
Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies; Final
Rule, Federal Register/Vol. 77, No. 217 November 8, 2012. https://www.gpo.gov/fdsys/pkg/FR-2012-1108/pdf/2012-26904.pdf
4 Medicare Program; FY 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting
Requirements; and Updates on Payment Reform; Final Rule, Federal Register/Vol. 78, No. 152 August 7, 2013.
https://www.gpo.gov/fdsys/pkg/FR-2013-08-07/pdf/2013-18838.pdf

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data is targeted for CY 2017. As such, the HIS v2.00.0 includes two new administrative items intended to
support public reporting.
The HIS v2.00.0 contains items to calculate the 7 adopted NQF measures (and thus the proposed
composite measure), the Hospice Visits when Death is Imminent measure pair, as well as administrative
items for patient record matching and future public reporting of hospice quality data.
Use of the HIS allows collection of standardized, patient-level data collection for quality reporting
purposes as part of the HQRP. The use of this HIS is necessary in order to allow CMS to collect quality
data from hospices in compliance with Section 3004 of the Affordable Care Act.
Section 3004 of the Affordable Care Act requires that the Secretary establish procedures for making the
data submitted for the HQRP available to the public. In general, any measures selected for the HQRP be
endorsed by the consensus-based entity which holds a contract regarding performance measurement with
the Secretary. This contract is currently held by NQF.
Implementation of the HIS v2.00.0 fulfills both of these requirements – the item set allows for
standardized, patient-level data collection of data elements required to calculate the aforementioned
quality measures. Secondly, data collection through the HIS has resulted in standardized data which can
be used to calculate the aforementioned quality measures in a manner consistent with the scientific
methods required to create a publicly reported quality measure under the HQRP. There are no other
reasonable or currently available alternatives for CMS to use for the collection of patient-level quality
data from hospices that would fulfill the requirements of publicly reporting quality measures, set forth in
the Affordable Care Act.
2. Purpose and Use of the Information Collection
All hospices providers must submit the specified type and amount quality data for participation in the
Hospice Quality Reporting program to avoid a 2 percentage point reduction in the market basket update
for FY 2014 and beyond.
There are two primary users of the Hospice QRP data. The first user is CMS, which collect this data as
required by Section 3004(c)(5)(A)(i) of the ACA (which added section 1814(i)(5)(A)(i) to the Social
Security Act). CMS uses the hospice quality data collected for the purpose of calculation of quality
measures, for determining provider compliance with the data reporting requirements of the Hospice QRP,
and at a later date for public reporting.
The second primary group of data users is the public, who will have access to this data after it is made
available by posting on the CMS website. Public reporting of the Hospice Quality Reporting Program
data will begin no earlier than spring/summer of 2017.
3. Use of Improved Information Technology and Burden Reduction
Hospices have the option of recording the required data on a printed form and later transferring the data to
electronic format, or they can choose to directly enter the required data electronically. Hospices use the
Quality Improvement Evaluation System (QIES) Assessment Submission and Processing (ASAP) system
for data submission, which is also currently used by Inpatient Rehabilitation Facilities (IRFs), Skilled
Nursing Facilities (SNFs), Long Term Care Hospitals (LTCHs), and Home Health Agencies (HHAs).
CMS requires that the collected data be transmitted to CMS electronically. This manner is similar to the
process that is also used by HHAs for the Outcome and Assessment Information Set, Version C (OASISC), SNFs for the Minimum Data Set (MDS 3.0), and IRFs for Inpatient Rehabilitation Facility Patient

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Assessment Instrument (IRF-PAI), and LTCHs for the LTCH Care Data Set. Hospices are required to
attest to the accuracy of the data collected for the HIS. However, if electronic signatures were to be
required at a future date, CMS could accommodate this as well.
4. Efforts to Identify Duplication and Use of Similar Information
This information collection does not duplicate any other effort, and the standardized data elements in the
HIS to collect data on pain, respiratory status, medications, patient preferences, beliefs/values, and visits
when death is imminent cannot be currently obtained from any other existing data source. There are no
other data sets that will provide comparable and standardized information on patients receiving hospice
care. The HIS v2.00.0 will replace the HIS v1.00.0.
5. Impact on Small Businesses or Other Small Entities
In order to minimize burden to hospices that qualify as small business entities, CMS is using a web-based
data submission process so that hospices can submit the specified data electronically. This minimizes the
burden that this ICR places on the provider. CMS is asking hospices to collect and submit data elements
that can be used to calculate six NQF-endorsed quality measures, a modification of one NQF-endorsed
measure, and two measures that are not yet NQF endorsed. A pilot test of the data collection for new
items showed that hospices of varying sizes (including several very small hospices) were able to find the
required data elements in their medical record systems and complete the HIS. There was minimal
difference between the burden of finding and recording the required data experienced by small versus
medium or large sized hospices. The amount and type of quality data specified for participation in the
HQRP is already currently collected by hospices as part of their patient care processes.
6. Consequences of Collecting the Information Less Frequently
The HIS will be used in hospices to collect quality data specific to the six NQF-endorsed quality
measures, a modification of one NQF-endorsed measure, and two measures that are not yet NQF
endorsed. Data collection is required for every patient admission and discharge. Hospices are required to
submit this data to CMS on a periodic basis.
Section 3004 (C) (which added 1814(i)(5)(A)(i) to the “Act”) required the Secretary to establish a quality
reporting program for hospices. This statute further required that, beginning with FY 2014, the Secretary,
reduce the market basket update by 2 percentage points for any hospice that does not submit quality data
submission for a fiscal year. CMS did begin collection hospice QRP data on 10/01/2012. To remain in
compliance with the ACA Section 3004 and 1814(i)(5)(A) of the Act, we must continue to collect
Hospice quality measure data and add new measures as appropriate.
7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5
No special circumstances apply to these collections.
8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the
Agency
A Federal Register notice will be published, providing the public with a 60-day period to submit written
comments on these information collection requirements (ICRs).
9. Explanation of Any Payment or Gift to Respondents
Respondents will not receive any payments or gifts as a condition of complying with these ICRs.

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10. Assurance of Confidentiality Provided to Respondents
The patient-level data collected using the HIS will be kept confidential by CMS. Data will be stored in a
secure format meeting all federal privacy guidelines. Data will be collected using a secure platform for
electronic data entry and secure data transmission. The electronic system will be password protected with
access limited to CMS and project staff. To protect patient confidentiality, the patient’s name will not be
linked to his/her individual data. For identification purposes, a unique identifier will be assigned to each
sample member.
All patient-level data is protected from public dissemination in accordance with the Privacy Act of 1974,
as amended. The information collected is protected and held confidential in accordance with 20 CFR
401.3. A System of Records will be established for this ICR prior to the time that it is implemented.
11. Justification for Sensitive Questions
This data collection does not incorporate any questions that would be considered sensitive in nature.
12. Estimates of Annualized Burden Hours and Costs
CMS estimates the burden to Hospice facilities to be calculated as follows:

PART 1. Time Burden
Estimated number of hospice admissions and Hospice Item Set record submissions
Total number of Medicare-participating hospices = 4,259 5
Total number of admissions to all hospices per year = 1,248,419 6
Total number of admissions to all hospices over three years = 3,745,257
Estimated average number of admissions to each hospice:
•
•
•

per year: 1,248,419 admissions to all hospices / 4,259 hospices = 293 admissions per
hospice per year
per month: 1,248,419 admissions to all hospices / 4,259 hospices / 12 months per year = 24
per month
over 3 years: 3,745,257 admissions to all hospices over 3 years / 4,259 hospices = 879 per 3
years

Estimated average number of Hospice Item Set records submitted by all hospices
•
•
•

per year: 1,248,419 admissions to all hospices per year x 2 Hospice Item Set records (1
Admission Record and 1 Discharge Record) per patient = 2,496,838 records per year
per month: 2,496,838 Hospice Item Set records per all hospices per year / 12 months per
year = 208,070 per month
over 3 years: 2,496,838 Hospice Item Set records per all hospices per year x 3 years =
7,490,514 per 3 years

5 Quality Improvement and Evaluation System (QIES) List of Hospice Providers, January 2016
6 The discharge number was calculated using the number of HIS discharge assessments submitted October 1, 2014 –

September 30, 2015.

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Estimated average number of Hospice Item Set records submitted by each hospice
•
•
•

per year: 2,496,838 Hospice Item Set records per all hospices / 4,259 hospices = 586
records per hospice per year
per month: 208,070 Hospice Item Set records per all hospices per month / 4,259 hospices =
49 per month
over 3 years: 7,490,514 Hospice Item Set records per all hospices per 3 years / 4,259
hospices = 1,759 per 3 years

PART 2. Cost/Wage Calculation
Note that this worksheet presents rounded inputs for each calculation. The actual calculations were
performed using unrounded inputs, so the outputs of each equation below may vary slightly from
what would be expected from the rounded inputs.
Time required to complete each Hospice Item Set record
14 minutes nursing/clinical staff time to abstract data for Admission Record – paid @
$67.10/hr. 7
9 minutes nursing/clinical staff time to abstract data for Discharge Record – paid @ $67.10/hr.
5 minutes administrative/clerical staff time to upload Assessment Record data – paid @
$32.24/hr. 8
5 minutes administrative/clerical staff time to upload Discharge Record data – paid @ $32.24/hr.
Nursing Time:
•
•
•
•
•

23 minutes x 293 Hospice Item Sets per each hospice per year / 60 minutes per hour =
112.36 nursing hours per each hospice per year
112.36 hours per year x $67.10 per hour = $7,539.66 nursing wages per each hospice per year
$7,539.66 per each hospice per year x 4,259 hospice providers = $32,111,417.38 nursing
wages per all hospices per year
$7,539.66 per each hospice per year x 3 years = $22,618.98 nursing wages per each hospice
over 3 years
$32,111,417.38 per all hospices per year x 3 years = $96,334,252.13 nursing wages for all
hospices over 3 years

Administrative Assistant Time:
•
•

10 minutes x 293 Hospice Item Sets per each hospice per year / 60 minutes per hour = 48.85
administrative/clerical hours per each hospice year
48.85 hours per year x $32.24 per hour = $1,575.06 administrative/clerical wages per each
hospice per year

7 The adjusted hourly wage of $67.10 per hour for a Registered Nurse was obtained using the mean hourly wage

from the U.S. Bureau of Labor Statistics, $33.55. This mean hourly wage is adjusted by a factor of 100 percent to
include fringe benefits. See http://www.bls.gov/oes/current/oes291141.htm
8 The adjusted hourly wage of $32.24 per hour for a Medical Secretary was obtained using the mean hourly wage
from the U.S. Bureau of Labor Statistics, $16.12. This mean hourly wage is adjusted by a factor of 100 percent to
include fringe benefits. See http://www.bls.gov/oes/current/oes436013.htm

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•
•
•

$1,575.06 per each hospice per year x 4,259 hospice providers = $6,708,171.43
administrative/clerical wages per all hospices per year
$1,575.06 per each hospice per year x 3 years = $4,725.17 administrative/clerical wages per
each hospice over 3 years
$6,708,171.43 per all hospices per year x 3 years = $20,124,514.28 administrative/clerical
wages per each hospice over 3 years

Total annualized cost to each hospice provider:
$7,539.66
$1,575.06

Nursing wages per each hospice per year
Administrative assistant wages per each hospice per year

$9,114.72

Total

Total annualized cost to all hospice providers:
$32,111,417
$6,708,171

Nursing wages per all hospice providers per year
Administrative assistant wages per all hospice providers per year

$38,819,589

Total

Total 3-year cost to each hospice provider:
$22,618.98
$4,725.17

Nursing wages per each hospice over 3 years
Administrative assistant wages per each hospice over 3 years

$27,344.16

Total

Total 3-year cost to all hospice providers:
$96,334,252
$20,124,514

Nursing wages per all hospice providers over 3 years
Administrative assistant wages per all hospice providers over 3 years

$116,458,766

Total

PART 3. Additional Calculations
Average monthly cost to each individual hospice provider:
$38,819,589 for all Hospices per year / 4,259 hospices / 12 months per year = $759.56
Cost to provider per each individual hospice patient:
$38,819,589 for all hospices per year / 1,248,419 Hospice Item Sets per year = $31.10

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Table 2. Summary of Burden Hours and Costs
OMB
Regulation Control
Number of
Section(s)
No.
Respondents
Hospice
09384,259
Item Set
1153
Admission
Assessment

Number of
Responses
1,248,419
per year

Hospice
0938Item Set
1153
Discharge
Assessment

4,259

1,248,419
per year

3-year total

4,259

7,490,514

09381153

Burden
per
Response
(hours)
0.233
clinician
hours;
0.083 clerical
hours
0.150
clinician
hours;
0.083 clerical
hours
0.55 hours

Total
Annual
Burden
(hours)
395,333
hours

291,298
hours

Hourly Labor
Cost of
Reporting ($)
Clinician at
$67.10 per hour;
Clerical staff at
$32.24 per hour
Clinician at
$67.10 per hour;
Clerical staff at
$32.24 per hour

2,059,89 Clinician at
1 hours
$67.10 per hour;
Clerical staff at
$32.24 per hour

Total Cost
($)
$22,900,166

$15,919,423

$116,458,766

13. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers
No anticipated capital costs since a web based interface is available to all providers to submit the requisite
information.
14. Annualized Cost to the Federal Government
The federal government will incur costs related to the HIS v2.00.0 for provider training, preparation of
HIS v2.00.0 manuals and materials, receipt and storage of data, data analysis, and upkeep of data
submission software.
There are costs associated with the maintenance and upkeep of a CMS-sponsored web-based program that
hospice providers will use to submit their HIS. The work to maintain this web-based data submission
platform will be performed by a CMS IT group known as the Division of Quality Systems for Assessment
& Surveys (DQSAS) or groups under contract with DQSAS to perform this work. DQSAS will use
approximately 0.5 FTE’s at a grade 13 or higher to manage the technology aspect of the Hospice Quality
Reporting Program. In addition, the federal government will also incur costs for help-desk support that
must be provided to assist Hospice the data submission process.
After Hospice providers submit HQRP data to CMS, this data is transmitted to a CMS contractor for
processing and analysis. Thereafter, the data is stored by another CMS contractor for future use. There are
costs associated with the transmission, analysis, processing and storage of the Hospice data by these CMS
contractors.
Also, pursuant to §1814 (i)(5)(A)(i) of the Act, Hospices that do not submit the required data will receive
a 2 percentage point reduction of their annual market basket increase. The federal government will incurs
additional costs associated with aggregation and analysis of the data necessary to determine provider
compliance with the reporting requirements for any given fiscal year.

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The total annual cost to the federal government for the implementation and ongoing management of HIS
data is estimated to be $1,583,500. These costs are itemized below:

ESTIMATED ANNUAL COSTS TO FEDERAL GOVERNMENT:
Create and Conduct Provider Web-based Training
Prepare and update HIS Manuals and Materials
Contractor Costs for Receipt and Storage of HIS Data
Cost for Aggregation & Data Analysis
Costs for Upkeep & Maintenance of HIS Data Submission
Software by CMS/DQSAS

TOTAL COST TO FEDERAL GOVERNMENT:

$
8,500
$ 25,000
$ 550,000
$ 500,000
$ 500,000

$1,583,500

15. Explanation for Program Changes or Adjustments
The attached Burden Estimate Calculation Worksheet (Exhibit A) provides a detailed explanation of the
burden we estimate hospice providers will experience as a result of reporting hospice quality measure
data using the new HIS v2.00.0. We estimate the annualized yearly burden per each hospice to be 161
hours, or $9,114.72, and the annualized burden across all hospices to be 686,630 hours, or $38,819,589.
In a previous PRA package, which was published in the Federal Register on August 7, 2013, 9 we
estimated that the total annualized burden to each hospice for the reporting of hospice quality measure
data would be $3,818.26 and the annualized burden across all hospices in the U.S. would be $14,287,929.
(See Exhibit B).
We have noted that there will be some increase in burden associated with the use of the HIS v2.00.0. We
estimate that the increase to each individual hospice will be approximately 21 hours, or $5,296, and the
total increase in burden across all 4,259 hospices will be approximately 160,803 hours, or $24,531,660.
(See Exhibit A, Appendix 4). We believe that this increase in burden can be attributed to several factors.
First, the burden calculation used in the previous PRA package was based on the use of the HIS v1.00.0.
HIS v2.00.0 includes 17 additional items for response: 3 new items in the Admission assessment, and 14
new items in the Discharge assessment. These additional items will be used for:
•
•
•

Data collection for a set of two paired quality measures under development to assess hospice
visits when death is imminent
Refinement of quality measure NQF #1637
Additional administrative items for patient record matching and future public reporting of hospice
quality data

In addition, the numbers of patients and hospices have increased. We use updated information from the
Center for Medicare regarding the current number of Medicare-participating hospices in the U.S. to
inform our burden calculations. This figure has increased since the previous PRA submission and thus has
increased the burden calculation included in this package.
Finally, this burden estimate uses new wage calculations as compared to the HIS v1.00.0 calculations. We
have adjusted all wage estimates by a factor of 100 percent to include fringe benefits. Because of this
9https://www.gpo.gov/fdsys/pkg/FR-2013-08-07/pdf/2013-18838.pdf

9

increase in the input wages, the change in cost to hospices appears to be much larger than the change in
burden hours.
This quality reporting program was mandated by Section 3004(c) of the Affordable Care Act,
(1814(i)(5)(A)(i) of the Social Security Act) and therefore, this burden is statutorily mandated:
•

•
•

In order for CMS to meet the requirements set forth in section added by section 3004 (c) of the
Patient Protection and Affordable Care Act) which states that the Secretary of the Department of
Health and Human Services should establish a quality reporting program for hospices by Fiscal
Year 2014.
In order for each hospice to comply with the reporting requirements of ACA Section 3004(c).
In order for each hospice to be entitled to receive their annual market basket for update beginning
in Fiscal Year 2014.

16. Plans for Tabulation and Publication and Project Time Schedule
At this time, CMS is making plans for the public reporting of Hospice quality measure data as required by
ACA 3004(c)(5)(E). This public reporting is tentatively planned to begin no earlier than spring/summer
2017.
17. Reason(s) Display of OMB Expiration Date is Inappropriate
CMS requests an exemption from displaying the expiration date of this PRA package approval, as these
forms are to be used on a continuing basis for hospices’ compliance with the requirements of the HQRP.
18. Exceptions to Certification for Paperwork Reduction Act Submissions
There are no exceptions to the certifications statement.

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