Information Collection Request

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

ICR 201607-0938-011 · OMB 0938-1109 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction Unchanged Available
CMS-10250 Supporting Statement Part B CY 2017 OPPS-ASC Proposed Rule.doc Supporting Statement B Uploaded 2016-07-19 Available
CMS-10250 Supporting Statement Part A - 07_05_2016 clean.doc Supporting Statement A Uploaded 2016-07-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2017 36 Months From Approved 10/31/2017
2,331,486 0 2,331,486
3,056,717 0 3,056,717
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital Outpatient Quality Reporting CY 2016 - CY 2018 CMS-10250, CMS-10250, CMS-10250, CMS-10250 Extroadinary Circumstances Form ,   Notice of Participation Form ,   Validation Review for Reconsideration Request ,   Reconsideration Request Form



Reginfo record details
  No