Information Collection Request

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

ICR 201708-0938-013 · OMB 0938-1109 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction Modified Available
CMS-10250 Supporting Statement Part B_CY 2018.doc Supporting Statement B Uploaded 2017-08-22 Available
CMS-10250 Supporting Statement A_ CY 2018 proposed rule 8-22-17.doc Supporting Statement A Uploaded 2017-08-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2018 36 Months From Approved 06/30/2018
2,331,986 0 2,331,986
3,444,227 0 3,444,227
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital Outpatient Quality Reporting CY 2016 - CY 2018 CMS-10250, CMS-10250 Notice of Participation Form ,   Validation Review for Reconsideration Request



Reginfo record details
  No