Information Collection Request

Hospital Outpatient Quality Reporting (OQR) Program (CMS-10250)

ICR 202401-0938-006 · OMB 0938-1109 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250. OQR_Rec CMS-10250. OQR_Reconsideration Form Form and Instruction Modified Available
Form CMS-10250.OQR_With CMS-10250.OQR_Withdraw Form Form and Instruction Modified Available
Form CMS-10250.CMS Qual CMS-10250.CMS Quality Program ECE Request Form_CY 2024_vFinal Form and Instruction Modified Available
Form CMS-10250 CMS-10250.OQR_Validation_Recon_Req_Form Form and Instruction Modified Available
Form CMS-10250 Web Based Data Collection Tool Form and Instruction Modified Available
Form CMS-10250 Hospital Outpatient Quality Reporting Form and Instruction Modified Repair queued
CMS-10250.Supporting Statement Part B (final rule).docx Supporting Statement B Uploaded 2024-01-17 Repair queued
CMS-10250.Supporting Statement Part A (final rule).docx Supporting Statement A Uploaded 2024-01-17 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250. OQR_Reconsideration Form
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250.OQR_Withdraw Form
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250.CMS Quality Program ECE Request Form_CY 2024_vFinal
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250.OQR_Validation_Recon_Req_Form
217995 Hospital Outpatient Quality Reporting Instruction Modified
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedWeb Based Data Collection Tool
217995 Hospital Outpatient Quality Reporting Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2026 36 Months From Approved 02/28/2025
968,150 0 968,150
276,148 0 291,604
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital Outpatient Quality Reporting CMS-10250, CMS-10250.OQR_Withdraw Form, CMS-10250, CMS-10250.CMS Quality Program ECE Request Form_CY , CMS-10250. OQR_Reconsideration Form ,   ,   ,   ,  

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 968,150 968,150 0 0 0 0
Annual Time Burden (Hours) 276,148 291,604 0 -15,456 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No