Physician Quality Reporting Initiative

Forms and Documents

Document Name	Status
Form CMS-10276 Physician Quality Reporting Initiative Form and Instruction	Removed
CMS-10276.Supporting Statement_Part B_.docx Supporting Statement B	2011-03-21
0938-1059 CMS-10276.Supporting_Statement_Part_A.doc Supporting Statement A	2011-08-15

IC Document Collections

IC ID	Document Title	Status
197031	Claims-based Reporting of the Electronic Prescribing Measure under GPRO II (2011)	New
197030	Claims-based Reporting of the Electronic Prescribing Measure under GPRO I (2011)	New
197029	Claims-based Reporting of the Electronic Prescribing Measure (2011)	New
197028	Registry-based Reporting By Group Practices under GPRO II	New
197027	Claims-based Reporting By Group Practices under GPRO II	New
197026	Group Practices Reporting under GPRO I	New
197025	EHR Vendor Self-nominating	New
197024	Registries Self-nominating for 2011	New
197023	EHR-based Reporting for Eligible Professionals (2011)	New
197022	Registry-based Reporting for Eligible Professionals (2011)	New
197021	Claims-based Reporting for Eligible Professionals (2011)	New
197020	Claims Based Reporting of the Electronic Prescribing Measure (Participating Group Practices - 2010)	New
197019	Claims Based Reporting of the Electronic Prescribing Measure (Eligible Professionals - 2010)	New
197018	Eligible Group Practice Reporting (2010)	New
197017	EHR Vendors Self-Nominating (2010)	New
197016	EHR-based Reporting for Individual Eligible Professionals (2010)	New
197015	Registries of Self-Nominating for 2010	New
197014	Registry-Based Reporting for Individual Eligible Professionals	New
197013	Claims-based Reporting for Individual Eligible Professionals	New
187959	Physician Quality Reporting Initiative Form and Instruction	Removed

ICR Details

OMB Control No: 0938-1059	ICR Reference No: 201103-0938-013
Status: Historical Active	Previous ICR Reference No: 200902-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Physician Quality Reporting Initiative
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/12/2011
	Date Received in OIRA: 03/21/2011
Terms of Clearance: Since the PQRI reporting requirements tend to change annually with each annual physician fee rule, this ICR is approved until July 2012. At that time, CMS should upload the ICR associated with the proposed rule for the CY 2012 physician fee schedule. The agency is reminded that it should clearly identify whether the changes to the collection are the result of a program change or an adjustment in the supporting statement. It is also noted that the agency has not requested approval based on the annual average of the burden imposed over the life of the approval. As a result, the burden is higher than necessary. To correct this error, the agency may submit a non-substantive change adjusting the burden hours.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	36 Months From Approved
Responses	8,077,366	0	0
Time Burden (Hours)	3,994,949	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection request includes the collection associated with the Physician Quality Reporting Initiative.

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Authorizing Statute(s): US Code: 42 USC 1395w-4 Name of Law: Payment for Physician' Services
   PL: Pub.L. 109 - 432 101 Name of Law: Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AP79	Final or interim final rulemaking	75 FR 73170	11/29/2010

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 40040	07/13/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 73170	11/29/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

IC Title	Form No.	Form Name
Claims-based Reporting of the Electronic Prescribing Measure under GPRO I (2011)
Claims-based Reporting of the Electronic Prescribing Measure under GPRO II (2011)
Claims Based Reporting of the Electronic Prescribing Measure (Eligible Professionals - 2010)
Claims Based Reporting of the Electronic Prescribing Measure (Participating Group Practices - 2010)
Claims-based Reporting for Individual Eligible Professionals
Registry-Based Reporting for Individual Eligible Professionals
Registries of Self-Nominating for 2010
EHR-based Reporting for Individual Eligible Professionals (2010)
EHR Vendors Self-Nominating (2010)
Eligible Group Practice Reporting (2010)
Claims-based Reporting for Eligible Professionals (2011)
Registry-based Reporting for Eligible Professionals (2011)
EHR-based Reporting for Eligible Professionals (2011)
Registries Self-nominating for 2011
EHR Vendor Self-nominating
Group Practices Reporting under GPRO I
Claims-based Reporting By Group Practices under GPRO II
Registry-based Reporting By Group Practices under GPRO II
Claims-based Reporting of the Electronic Prescribing Measure (2011)
Physician Quality Reporting Initiative	CMS-10276	2008 PQRI Measure Specifications

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ICR Summary 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	8,077,366	0	0	-8,787,000	0	16,864,366
Annual Time Burden (Hours)	3,994,949	0	0	-1,125,935	0	5,120,884
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The reductions are an adjustment. Because of a reorganization in the ICs and the removal of an IC, ROCIS has classified the change as a program change by default.

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Annual Cost to Federal Government: $341,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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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: 03/21/2011

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