Hospice Quality Reporting Program (CMS-10390)

ICR 202104-0938-013

OMB: 0938-1153

Federal Form Document

Forms and Documents
ICR Details
0938-1153 202104-0938-013
Received in OIRA 202010-0938-011
Hospice Quality Reporting Program (CMS-10390)
Extension without change of a currently approved collection   No
Regular 04/26/2021
  Requested Previously Approved
36 Months From Approved 02/29/2024
4,688 4,688
636,312 636,312
0 0

Section 3004(c) of the Patient Protection and Affordable Care Act (ACA), (which added section 1814(i)(5) to the Social Security Act) ), authorized the Secretary to establish a quality reporting program for hospices. Section 1814(i)(5)(A)(i) of the Social Security Act required that the Secretary, beginning with FY 2014, reduce the market basket update by 2 percentage points for any hospice that does not submit quality data submission for a fiscal year. During the first "mandatory" reporting period, hospices were required to gather data pertaining to two quality measures: (1) a structural measure titled "Participation in a Quality Assessment and Performance Improvement (QAPI) Program that Includes at Least Three Quality Indicators Related to Patient Care" and; (2) the National Quality Forum (NQF)-endorsed #0209 pain measure. Hospice providers were then required to report their data between 01/01/2012 and 04/01/2012 In the CY 2013 HH PPS final rule (77 FR 67132 through 67136), CMS retained the two measures that had previously been adopted in the FY 2012 rule. Hospices will continue to collect data for these measures until December 31, 2013. Beginning on July, 1, 2014, hospices shall begin to collect quality measure data using a newly created set of data elements which are collectively titled as the "Hospice Item Set." The Hospice Item Set, which was developed specifically for use in the hospice setting, contains data elements that are used to collect standardized, patient-level data. This data can be used, at a later date, to calculate six NQF-endorsed quality measures and a modification of one NQF-endorsed measure. For more details about the Hospice Item Set, refer to Section 1 of the Supporting Statement A.

PL: Pub.L. 111 - 148 3004 Name of Law: Patient Protection and Affordable Care Act

0938-AU41 Proposed rulemaking 86 FR 19700 04/14/2021


IC Title Form No. Form Name
Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form CMS-10390, CMS-10390, CMS-10390 Hospice Item Set - Descriptions ,   Hospice Item Set - Admissions ,   Hospice Item Set - Discharge

  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 4,688 4,688 0 0 0 0
Annual Time Burden (Hours) 636,312 636,312 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0

Jamaa Hill 301 492-4190


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:
    (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;
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.

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