Per previous conversations regarding exemption from the display of the expiration date, this request has been returned to the agency as improperly submitted due to an insufficient justification for the exemption.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
04/30/2017
36 Months From Approved
04/30/2017
3,742
0
3,742
525,827
0
525,827
0
0
0
Section 3004(c) of the Patient Protection and Affordable Care Act (ACA), (which added section 1814(i)(5) to the Social Security Act) ), authorized the Secretary to establish a quality reporting program for hospices. Section 1814(i)(5)(A)(i) of the Social Security Act required that the Secretary, beginning with FY 2014, reduce the market basket update by 2 percentage points for any hospice that does not submit quality data submission for a fiscal year. During the first "mandatory" 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), CMS retained the two measures that had previously been adopted in the FY 2012 rule. Hospices will continue to collect data for these measures until December 31, 2013.
Beginning on July, 1, 2014, hospices shall begin to collect quality measure data using a newly created set of data elements which are collectively titled as the "Hospice Item Set." The Hospice Item Set, which was developed specifically for use in the hospice setting, contains data elements that are used to collect standardized, patient-level data. This data can be used, at a later date, to calculate six NQF-endorsed quality measures and a modification of one NQF-endorsed measure. For more details about the Hospice Item Set, refer to Section 1 of the Supporting Statement A.
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.
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 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.
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:
(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;
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.
Form CMS-10390 Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form
CMS-10390 - Supporting Statement Part A_HIS_FINAL.docx
CMS-10390 Exhibit A FY 2017 Hospice PRA Burden Estimate Calculation Worksheet.pdf
Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form