Quality Improvement Strategy Implementation Plan and Progress Report (CMS-10540)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10540 Quality Improvement Strategy Implementation Plan and Progress Report Form	Form and Instruction	Modified	Repair queued
CMS 10540 - NonSubtantive Change Request- COVID19 MQI memo.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-05-21	Available
CMS-10540-30-day-Supporting-Statement-COVID19 revisions.docx	Supporting Statement A	Uploaded 2020-05-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217708	Quality Improvement Strategy Implementation Plan and Progress Report Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1286	ICR Reference No: 202005-0938-011
Status: Active	Previous ICR Reference No: 201809-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Quality Improvement Strategy Implementation Plan and Progress Report (CMS-10540)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/16/2020
	Date Received in OIRA: 05/27/2020
Terms of Clearance: Prior terms of clearance continue. Upon resubmission, CMS is encouraged to provide pre-populated QIS forms to issuers, as requested by two public commenters--or if this is not possible, to clearly explain why the agency is unable to do this in Supporting Statement A.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2020	12/31/2020	12/31/2020
Responses	250	0	250
Time Burden (Hours)	24,000	0	36,000
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 1311(c)(1)(E) of the Affordable Care Act requires qualified health plans (QHPs) offered through an Exchange must implement a quality improvement strategy (QIS) as described in section 1311(g)(1). Section 1311(g)(1) of the Affordable Care Act describes this strategy as a payment structure that provides increased reimbursement or other incentives to improve the health outcomes of plan enrollees, prevent hospital readmissions, improve patient safety and reduce medical errors, promote wellness and health, and reduce health and health care disparities. Section 1311(g)(2) of the Affordable Care Act requires the Secretary to develop guidelines associated with 1311 (g)(1). Section 1311(g)(3) of the Affordable Care Act specifies the guidelines under Section 1311(g)(2) shall require the periodic reporting to the applicable Exchange the activities that a qualified health plan has conducted to implement a strategy as described in section 1311(g)(1). CMS is requesting approval for information collection associated with the QIS implementation plan and reporting to the applicable Exchange.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(e)(3) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 148 1311(c)(1) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 148 1311(g) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1311(c)(1) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 148 1311(g) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 148 1311(e)(3) Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 23280	05/18/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 43690	08/27/2018
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Quality Improvement Strategy Implementation Plan and Progress Report Form	CMS-10540	QIS Consolidated Plan and Progress Report Form

---

ICR Summary of Burden

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	250	250	0	0	0	0
Annual Time Burden (Hours)	24,000	36,000	0	0	-12,000	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: Revisions to the QIS form are minor, resulting in no change to the burden estimate of the hours needed to fill out the QIS form. The estimated number of issuers making QIS submissions is 250, the overall burden has decreased from 36,000 hours per year to 24,000 hours per year. In calendar year 2020, there is an additional decrease in burden hours of 48 hours due to CMS’ suspension of data collection resulting in an overall three year burden from 2018-2020 of 96 hours.

---

Annual Cost to Federal Government: $343,414

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? Yes

---

Common Form ICR:  No

---

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: 05/27/2020

---