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 PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program	Form and Instruction	Modified	Repair queued
CMS-10431 Supporting Statement A - FY 2021(PCHQR) 10-9-20.docx	Supporting Statement A	Uploaded 2020-10-16	Repair queued

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

ICR Details

OMB Control No: 0938-1175	ICR Reference No: 202010-0938-009
Status: Received in OIRA	Previous ICR Reference No: 202004-0938-007
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	Date Submitted to OIRA: 10/20/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2022
Responses	142,406	142,406
Time Burden (Hours)	75,779	75,779
Cost Burden (Dollars)	0	0

---

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.

---

Authorizing Statute(s): PL: Pub.L. 111 - 48 3005 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AU11	Final or interim final rulemaking	85 FR 58432	09/18/2020

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

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	Notice of Participation ,   Oncology Cares Measures Paper Submission ,   EBRT Pop Sample Application ,   EBRT Paper based ,   Oncology Care Measures Pop Sample application ,   Measure Exception Form ,   Data Accuracy and Completeness Form

---

ICR Summary of Burden

table that charts list 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	142,406	142,406	0	0	0	0
Annual Time Burden (Hours)	75,779	75,779	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:

---

Annual Cost to Federal Government: $24,462

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? No

---

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: 10/20/2020

---