Hospital Outpatient Quality Reporting (OQR) Program (CMS-10250)
Revision of a currently approved collection
No
Regular
10/10/2024
Requested
Previously Approved
36 Months From Approved
11/30/2026
968,150
968,150
54,189,977
276,148
0
0
Section 109(a) of the Tax Relief and Health Care Act of 2006 (TRHCA) (Pub. L. 109-432) amended section 1833(t) of the Social Security Act by adding a new subsection (17) that affects the payment rate update applicable to Outpatient Prospective Payment System (OPPS) payments for services furnished by hospitals in outpatient settings on or after January 1, 2009. Section 1833(t)(17)(A) of the Social Security Act, which applies to hospitals as defined under section 1886(d)(1)(B) of the Social Security Act, requires that hospitals that fail to report data required for quality measures selected by the Secretary in the form and manner required by the Secretary under section 1833(t)(17)(B) of the Social Security Act will incur a reduction in their annual payment update (APU) factor to the hospital outpatient department fee schedule by 2.0 percentage points.
Hospital OQR Program payment determinations are made based on Hospital OQR Program quality measure data reported and supporting forms submitted by hospitals as specified through rulemaking. To reduce burden, a variety of different data collection mechanisms are employed, with every consideration taken to employ existing data and data collection systems.
For the CY 2025 reporting period/CY 2027 payment determination, based on the policy proposals in the CY 2025 OPPS/ASC proposed rule, we estimate a total burden of 16,855,645 hours at a cost of $420,225,865 (an increase of 16,576,356 and $406,169,218 from our estimate in the CY 2024 OPPS/ASC final rule). This burden estimate also represents an increase of 16,593,108 and $406,542,452 from the currently approved burden estimate of 262,537 hours and $13,683,413 for the CY 2024 reporting period/CY 2026 payment determination.
The proposed adoption of the HCHE measure would result in a total estimated burden increase of 533 hours at a cost of $29,518 beginning with the CY 2027 payment determination. The proposed adoption of the Screening for SDOH and Screen Positive Rate for SDOH measures would result in a total estimated burden increase of 16,462,369 hours at a cost of $403,179,882 and 533 hours at a cost of $29,518, respectively, when mandatory reporting begins for the CY 2028 payment determination. The proposed adoption of the Information Transfer PRO-PM would result in a total estimated burden increase of 49,884,885 hours at a cost of $1,221,697,298 when mandatory reporting begins for the CY 2028 payment determination.
Accounting for the impact of the proposals in the CY 2025 OPPS/ASC proposed rule, our updated estimate of the number of HOPDs results in an annual burden decrease of 11,723 hours and $649,408 beginning with the CY 2027 payment determination. The aggregate increase due to these policies and adjustments as reflected in our burden estimates for the CY 2030 payment determination is 66,336,597 hours (-11,723 + 533 + 16,462,369 + 533 + 49,884,885) and $1,624,286,808 (-649,408 + $29,518 + $403,179,882 + $29,518 + $1,221,697,298) as shown in Tables 7 and 8.
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.