Information Collection Request

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

ICR 201712-0938-021 · OMB 0938-1109 · Historical Active

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 HOQR_SS Part B CY 2018 OPPS-ASC Final Rule Clean.doc Supporting Statement B Uploaded 2018-01-08 Available
CMS-10250 Supporting Statement A_ HOQR CY 2018 Final rule_11.1.2017.doc Supporting Statement A Uploaded 2017-12-29 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
03/31/2021 36 Months From Approved 06/30/2018
2,331,986 0 2,331,986
2,221,516 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

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 2,331,986 2,331,986 0 0 0 0
Annual Time Burden (Hours) 2,221,516 3,444,227 0 -1,222,711 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No