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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10431 Notice of Participation	Form and Instruction	Modified	Available
Form CMS-10431 Data Accuracy and Completeness Form	Form and Instruction	Modified	Available
Form CMS-10431 Oncology Cares Measures Paper Submission	Form and Instruction	Modified	Available
Form CMS-10431 Measure Exception Form	Form and Instruction	Modified	Available
Form CMS-10431 Oncology Care Measures Pop Sample application	Form and Instruction	Modified	Available
Form CMS-10431 EBRT Paper based	Form and Instruction	Modified	Available
Form CMS-10431 EBRT Pop Sample Application	Form and Instruction	Modified	Available
Form CMS-10431 Oncology Care Measures Paper Submission	Form and Instruction	Modified	Available
CMS-10431 PCHQR Supporting Statement A - FY 2020 .docx	Supporting Statement A	Uploaded 2019-05-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Notice of Participation
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Data Accuracy and Completeness Form
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Oncology Cares Measures Paper Submission
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Measure Exception Form
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Oncology Care Measures Pop Sample application
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	EBRT Paper based
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	EBRT Pop Sample Application
202342	PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Oncology Care Measures Paper Submission

ICR Details

OMB Control No: 0938-1175	ICR Reference No: 201905-0938-010
Status: Historical Inactive	Previous ICR Reference No: 201812-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program (CMS-10431)
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: 10/07/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/22/2019
Terms of Clearance: Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2022	36 Months From Approved	01/31/2022
Responses	108,500	0	108,500
Time Burden (Hours)	75,782	0	75,782
Cost Burden (Dollars)	0	0	0

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Abstract: Section 3005 of the Affordable Care Act authorizes the establishment of a quality reporting program for PPS-exempt cancer hospitals (PCHs). This is an update to the previously approved PCHQR Program PRA submission. We are proposing to remove one web-based, structural quality measure and are requesting a revision of the currently approved collection to reduce the estimated burden.

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Authorizing Statute(s): PL: Pub.L. 111 - 48 3005 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-AT73	Proposed rulemaking	84 FR 19158	05/03/2019

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Federal Register Notices & Comments

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
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

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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: We are reducing a previously approved burden. We are proposing the removal of one (1) web-based structural measure from the PCHQR Program, which will reduce the information collection burden on the PCHs. The change in the burden associated with these finalized policies is a reduction of approximately 3 hours (.25 fewer hours per year per PCH for the proposed removal of the web-based structural measure x 11 PCHs) across all 11 PCHs annually.

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Annual Cost to Federal Government: $20,800

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: 05/22/2019

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