Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)

Forms and Documents

Document Name	Status
Form CMS-10652 MIPS: Virtual Group Election Process Form and Instruction	Modified
CMS-10652 VG for MIPS Supporting Statement A (02-03-20).docx Supporting Statement A	2020-05-07

IC Document Collections

IC ID	Document Title	Status
228101	MIPS: Virtual Group Election Process Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1343	ICR Reference No: 202005-0938-002
Status: Received in OIRA	Previous ICR Reference No: 201708-0938-026
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/07/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	16	16
Time Burden (Hours)	160	160
Cost Burden (Dollars)	0	0

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Abstract: CMS is requesting clearance for the statutorily required virtual group election process finalized in the CY 2018 Quality Payment Program final rule. As outlined in section 1848(q)(5)(I)(iii) of the Social Security Act (hereafter the Act) as amended by section 101 of MACRA, a virtual group is a combination of TINs, which would include at least two separate TINs associated with a solo practitioner (TIN/NPI) or group with 10 or fewer MIPS eligible clinicians and another solo practitioner (TIN/NPI) or group with 10 or fewer MIPS eligible clinicians. In the CY 2018 Quality Payment Program final rule, we finalized that once the election request is approved by CMS, each virtual group will receive a virtual group identifier that will be used for purposes of virtual group submission of quality, Promoting Interoperability, and improvement activities performance category data on behalf of its participating clinicians. We also finalized to use the virtual group identifier for calculation of a final score and the associated MIPS payment adjustment for the virtual group, and to provide performance feedback for each virtual group.

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Authorizing Statute(s): PL: Pub.L. 14 - 10 101 Name of Law: MACRA
   PL: Pub.L. 114 - 10 1848(q)(5)(I)(iii) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 10701	02/25/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 27226	05/07/2020
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
MIPS: Virtual Group Election Process	CMS-10652	Virtual Group Agreement Template

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ICR Summary of Burden

	Total Request	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	16	16	0	0	0	0
Annual Time Burden (Hours)	160	160	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $275,000

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]? No

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)? Yes

Is this ICR related to the Pandemic Response? No

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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: 05/07/2020

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