Hospital Outpatient Quality Reporting CY 2016 - CY 2018

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

OMB: 0938-1109

IC ID: 217995

Information Collection (IC) Details

View Information Collection (IC)

Hospital Outpatient Quality Reporting CY 2016 - CY 2018
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10250 Extroadinary Circumstances Form ExtrdnryCircumForm_121714.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250 Notice of Participation Form OQR Notice of Participation.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250 Validation Review for Reconsideration Request OQR_Form_ValidnReviewReq_7.8.2015.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250 Reconsideration Request Form OQR_ReconReqForm_070815.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

3,300 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,331,486 0 0 0 0 2,331,486
Annual IC Time Burden (Hours) 3,056,717 0 0 0 0 3,056,717
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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