Information Collection Request

(CMS-10431) PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program

ICR 201705-0938-015 · OMB 0938-1175 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10431 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program Form and Instruction Modified Available
CMS-10431 PQ 2017-06-02 v2 Supporting Statement A (PCHQR) - clean.docx Supporting Statement A Uploaded 2017-06-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
202342 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2019 36 Months From Approved 09/30/2019
400,631 0 400,631
200,425 0 200,425
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431, CMS-10431 Oncology Care Measures Paper Submission ,   EBRT Pop Sample Application ,   EBRT Paper based ,   Oncology Care Measures Pop Sample application ,   Measure Exception Form ,   Oncology Cares Measures Paper Submission ,   Data Accuracy and Completeness Form ,   Notice of Participation



Reginfo record details
  No