Hospital Outpatient Quality Reporting CY 2016 - CY 2018

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1109 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10250 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction
CMS-10250 Notice of Participation Form OQR Notice of Participation.pdf Form and Instruction
CMS-10250 Validation Review for Reconsideration Request OQR_Form_ValidnReviewReq_7.8.2015.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Hospital Outpatient Quality Reporting CY 2016 - CY 2018	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,331,986	500	2,331,486
Annual IC Time Burden (Hours)	3,444,227	387,510	3,056,717
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.