Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10432 Inpatient Psychiatric Facility Quality Reporting Program	Form and Instruction	Modified	Available
IPFQR Supporting Statement v2 (rev 05-17-2018 by OSORA PRA).docx	Supporting Statement A	Uploaded 2018-05-17	Available
IPFQR Crosswalk.xlsx	Supplementary Document	Uploaded 2018-05-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202349	Inpatient Psychiatric Facility Quality Reporting Program	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1171	ICR Reference No: 201805-0938-005
Status: Historical Inactive	Previous ICR Reference No: 201709-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 11/30/2018
	Date Received in OIRA: 05/17/2018
Terms of Clearance: The information collection requirements associated with this proposed rule are not approved at this time. CMS will review any comments received on this collection in the context of the rule and resubmit at the final rule stage.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	36 Months From Approved	07/31/2019
Responses	1,428,032	0	1,428,032
Time Burden (Hours)	4,662,154	0	4,662,154
Cost Burden (Dollars)	0	0	0

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Abstract: Section 10322 of the Affordable Care Act (ACA) authorizes the establishment of a new quality reporting program for Inpatient Psychiatric Facilities (IPFs). The program began with an initial set of 6 measures for FY 2014 and FY 2015 and currently includes 18 measures. For FY 2020 we propose adding one measure calculated from administrative claims. IPFs that fail to comply with the program’s requirements will receive a 2% reduction in their Annual Payment Update (APU). To minimize burden and maximize efficiency, CMS has leveraged existing systems within CMS to collect aggregated data and calculated measure rates from the IPFs, in a form, manner and time as specified by CMS, via a secure portal known as the QualityNet Web site. CMS will use the FY 2014 procedural requirements designed to align with current quality reporting programs. These procedural requirements involve submitting necessary forms (e.g., Notice of Participation Form, Reconsideration Request Form) to comply with the program and align with current CMS reporting requirements for other hospital quality reporting programs. When adding new measures, the law requires CMS, where “feasible and practical”, to select measures put forward by “one or more national consensus building entities”. Section 3013 of the ACA requires CMS to perform a gap analysis for needed quality measures every three years. Section 3014 of the ACA requires CMS to develop quality and efficiency measures through a “consensus-based entity”. Consequently, the Measure Applications Partnership (MAP), convened by the National Quality Forum (NQF), was formed to develop measures consistent with these requirements. CMS reviewed the MAP’s formal recommendations prior to identifying IPFQR measures for the FY 2018 IPPS/LTCH PPS rule.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 10322 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT32	Proposed rulemaking	83 FR 21104	05/08/2018

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 21104	05/08/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Inpatient Psychiatric Facility Quality Reporting Program	CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432	IPF Data Accuracy Form ,   HBIPS Measures Data Collection Tool ,   Vendor Authorization Form ,   Online Data Entry Tool Content for Structural Measures ,   FY 2019 Non-Measure Data Collection Paper Tool ,   IPF Screen shots ,   Notice of Participation ,   Online Data Entry Tool Content for Web-Based Measure Collection ,   Screening for Metabolic Disorders ,   Transitions Measures Collection Form ,   Substance Use Measure Collection

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This information collection request is associated with the May 8, 2018 (83 FR 21104) Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) proposed rule: CMS-1690-P (RIN 0938-AT32). As indicated below, the proposed rule would remove 8 of the 18 measures from the IPFQR Program and remove one of the five non-measure data elements.

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Annual Cost to Federal Government: $109,900

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/17/2018

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