(CMS-R-71) Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-R-71 Final Supporting Statement 1-9-18 .docx	Supporting Statement A	Uploaded 2018-01-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8057	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 412.44		Unchanged
225798	QIO Assumption of Responsibilities and Supp Regs in 42 CFR Sections 476.78 (b)(2)		New
225796	QIO Assumption of Responsibilities and Supp Reg. in 42 CFR Sections 431.630		New
185531	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.78(b)(3)		Unchanged
185530	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.74(c)		Modified
185529	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.74(b)		Unchanged
185528	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.73(b)(2)		Unchanged
185527	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.73(b)(1)		Modified
185525	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.71		Modified
185524	QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 412.46		Modified

ICR Details

OMB Control No: 0938-0445	ICR Reference No: 201702-0938-015
Status: Active	Previous ICR Reference No: 201311-0938-029
Agency/Subagency: HHS/CMS	Agency Tracking No: 20985
Title: (CMS-R-71) Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/02/2018
	Date Received in OIRA: 02/27/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	02/28/2018
Responses	972,478	0	56,377
Time Burden (Hours)	1,034,655	0	100,065
Cost Burden (Dollars)	0	0	0

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Abstract: The Peer Review Improvement Act of 1982 amended Title XI of the Social Security Act to create the Utilization and Quality Control Peer Review Organization (PRO) program which replaces the Professional Standards Review Organization (PSRO) program and streamlines peer review activities. The term PRO has been renamed quality Improvement Organization (QIO). This collection describes the review functions to be performed by the QIO. It outlines relationships among QIOs, providers, practitioners, beneficiaries, intermediaries, and carriers.

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Authorizing Statute(s): PL: Pub.L. 98 - 389 Deficit Reduction Act of 1984 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 90360	12/14/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11222	02/21/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 412.44
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 412.46
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.71
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.73(b)(1)
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.73(b)(2)
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.74(b)
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.74(c)
QIO Assumption of Responsibilities and Supp. Regs. in 42 CFR Sections 476.78(b)(3)
QIO Assumption of Responsibilities and Supp Reg. in 42 CFR Sections 431.630
QIO Assumption of Responsibilities and Supp Regs in 42 CFR Sections 476.78 (b)(2)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	972,478	56,377	0	919,520	-3,419	0
Annual Time Burden (Hours)	1,034,655	100,065	0	934,589	1	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The implementation of a new coding system (International Classification of Disease (ICD) 10) resulted in hospitals learning the new system and an increase in higher weighted DRG payment requests. Thus, a reduction in participating facilities has led to an increased workload of 934,590 reviews annually resulting in a burden from 100,065 to 1,034,655.

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Annual Cost to Federal Government: $29,953

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

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: 02/27/2017

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