PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program

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

OMB: 0938-1175

IC ID: 202342

Information Collection (IC) Details

View Information Collection (IC)

PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10431 Oncology Care Measures Paper Submission Form OCMs_PopSamp_paperbased_ April 17 2014_03242017 (508)[2].docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 EBRT Pop Sample Application Form EBRT_webapplication_July_24_2014_03242017 (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 EBRT Paper based Form EBRT_PopSamp_paperbased_ July_22_2014_03242017 (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 Oncology Care Measures Pop Sample application Form OCMs PopSample_application_April 17 2014_03242017 (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 Measure Exception Form PCH Measure Exception Form_01022014_updated_03242017 (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 Oncology Cares Measures Paper Submission Data Collection - Oncology Care Measures Paper Form (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 Data Accuracy and Completeness Form PCH DACA Form_03_31_2016_03242017 (508).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10431 Notice of Participation PCH NOP Paper Form_03242017 (508).docx Yes Yes Fillable Fileable

Health Health Care Services

 

11 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 325,501 0 -75,130 0 0 400,631
Annual IC Time Burden (Hours) 158,887 0 -41,538 0 0 200,425
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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