Information Collection Request

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

ICR 201709-0938-005 · OMB 0938-1175 · Historical Active

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 Unchanged Available
CMS-10431 Supporting Statement A - 3-1-18.docx Supporting Statement A Uploaded 2018-03-20 Available

IC Document Collections

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

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
325,501 0 400,631
158,887 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

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


Reginfo record details
  No