Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)

Forms and Documents

Document Name	Status
Form CMS-10250 Hospital Outpatient Quality Reporting Form and Instruction	Unchanged
CMS-10250 -Supporting Statement B CY2020 11-13-19 V2.docx Supporting Statement B	2019-11-26
CMS-10250 Supporting Statement A CY2020 11-13-19 V2.docx Supporting Statement A	2019-11-26

IC Document Collections

IC ID	Document Title	Status
217995	Hospital Outpatient Quality Reporting Form and Instruction	Unchanged

ICR Details

OMB Control No: 0938-1109	ICR Reference No: 201911-0938-015
Status: Active	Previous ICR Reference No: 201909-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: 21225
Title: Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)
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: 03/03/2020
	Date Received in OIRA: 11/26/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved	01/31/2022
Responses	3,125,100	0	3,125,100
Time Burden (Hours)	1,387,119	0	1,387,670
Cost Burden (Dollars)	0	0	0

---

Abstract: 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 Act, which applies to hospitals as defined under section 1886(d)(1)(B) of the 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 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.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 3014 Name of Law: Affordable Care Act
   PL: Pub.L. 109 - 432 109(a) Name of Law: Quality reporting for hospital outpatient services and ambulatory surgical center services
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT74	Final or interim final rulemaking	84 FR 61142	11/12/2019

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Hospital Outpatient Quality Reporting	CMS-10250	Validation Review for Reconsideration Request

---

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	3,125,100	3,125,100	0	0	0	0
Annual Time Burden (Hours)	1,387,119	1,387,670	0	-551	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: In the CY 2020 OPPS/ASC final rule, we are finalizing the removal of one web-based measure (OP-33) for the CY 2022 payment determination and subsequent years. In total, for the CY 2022 payment determination for the Hospital OQR Program, our estimates show an annual reduction in hourly burden of 551 hours (1,387,670 hours approved –1,387,119 total estimated hours for CY 2022). Although we estimate a reduction in burden hours, due to the increase in the estimated wage rate (from $36.58/hour last year to $38.80/hour this year) we are seeking approval for a $3,059,246 increase in the total cost for the CY 2022 payment determination for the Hospital OQR Program.

---

Annual Cost to Federal Government: $10,326,000

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

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]? No

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

---

Common Form ICR:  No

---

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: 11/26/2019

---