Marketplace Quality Standards (CMS-10520)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10520 Vendor Appeal Form	Form and Instruction	Modified	Available
Form CMS-10520 Monitoring and appeals process for survey vendors	Form and Instruction	Modified	Repair queued
CMS-10520 - Supporting Statement - 30-day.docx	Supporting Statement A	Uploaded 2025-08-13	Available
CMS-10520 - Supporting Statement - 30-day.docx	Supporting Statement A	Uploaded 2025-08-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212995	Patient safety reporting standards for QHP issuers		Modified
212994	Reporting for the Enrollee Satisfaction Survey (ESS)		Modified
212992	Implementation and reporting for the Quality Rating System (QRS)		Modified
212011	Monitoring and appeals process for survey vendors	Form and Instruction	Modified	Vendor Appeal Form
212011	Monitoring and appeals process for survey vendors	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1249	ICR Reference No: 202508-0938-006
Status: Active	Previous ICR Reference No: 202206-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Marketplace Quality Standards (CMS-10520)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/23/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/13/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2029	36 Months From Approved	02/28/2026
Responses	1,146	0	914
Time Burden (Hours)	522,126	0	384,014
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(3) of the Affordable Care Act directs the Secretary to develop a system to rate QHPs on the basis of quality and price and requires Exchanges to display this quality rating information on their respective websites. Section 1311(c)(4) of the Affordable Care Act requires the Secretary to develop an enrollee satisfaction survey (ESS) system to assess enrollee experience with each QHP (with more than 500 enrollees in the previous year) offered through an Exchange. Section 1311(h) requires QHPs to contract with certain hospitals that meet specific patient safety and health care quality standards beginning January 1, 2015. CMS is requesting approval for information collection associated with these related Marketplace quality standards.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(h) Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1311(c)(3)-(4) Name of Law: Affordable Care Act
   US Code: 45 USC 156.1110 Name of Law: HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCH
  

Citations for New Statutory Requirements: US Code: 45 USC 156.1110 Name of Law: Establishment of patient safety standards for QHP issuers.

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 87374	11/01/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 27539	06/27/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Implementation and reporting for the Quality Rating System (QRS)
Monitoring and appeals process for survey vendors	CMS-10520	Vendor Appeal Form
Patient safety reporting standards for QHP issuers
Reporting for the Enrollee Satisfaction Survey (ESS)

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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	1,146	914	0	0	232	0
Annual Time Burden (Hours)	522,126	384,014	0	0	138,112	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: This is an overall increase to the burden hour estimates approved in OMB Control Number 0938-1249. The modifications to the QRS and QHP Enrollee Survey and patient safety portions of this document, based on the past three years of implementation of the programs, would result in an annual estimate increase in burden hours of 138,112 hours. • QRS implementation and reporting increased by 133,880 hours [from 368,100 to 501,980 hours]; • QHP Enrollee Survey implementation and reporting increased by 4,000 hours [from 15,000 to 19,000 hours]; • Monitoring and appeals process for survey vendors decreased by 8 hours [from 14 to 6 hours]; • Patient safety collection and reporting increased by 240 burden hours [from 900 to 1,140 hours].

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Annual Cost to Federal Government: $651,446

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

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Common Form ICR:  No

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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: 08/13/2025

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