Quality Measures and Procedures for Hospital Reporting of Quality Data

Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)

OMB: 0938-1022

IC ID: 204350

Documents and Forms

Document Name Document Type
Form CMS-10210 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
CMS-10210 Data Accuracy and Completeness Form 2. Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA).pdf Form and Instruction
CMS-10210 Data Accuracy and Completeness Form 2. Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA).pdf Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form 9. Hospital Value-Based Purchasing (VBP) Program Review and Corrections Request Form.pdf Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form 9. Hospital Value-Based Purchasing (VBP) Program Review and Corrections Request Form.pdf Form and Instruction
CMS-10210 Extraordinary Circumstances Form 7. CMS Quality Program ECE Request Form_CY 2022(508)ff.pdf Form and Instruction
CMS-10210 Extraordinary Circumstances Form 7. CMS Quality Program ECE Request Form_CY 2022(508)ff.pdf Form and Instruction
CMS-10210 Hospital Compare Request Form for Withholding/Footnoting 3. Care Compare Withholding Footnoting Request Form_CY 2022.pdf Form and Instruction
CMS-10210 Hospital Compare Request Form for Withholding/Footnoting 3. Care Compare Withholding Footnoting Request Form_CY 2022.pdf Form and Instruction
CMS-10210 IQR Measure Exception Form 4. IPPS Measure Exception Form for PC 01 and SSI Measures.pdf Form and Instruction
CMS-10210 IQR Measure Exception Form 4. IPPS Measure Exception Form for PC 01 and SSI Measures.pdf Form and Instruction
CMS-10210 IQR Notice of Participation Form 1. Hospital Inpatient Quality Reporting Notice of Participation.pdf Form and Instruction
CMS-10210 IQR Notice of Participation Form 1. Hospital Inpatient Quality Reporting Notice of Participation.pdf Form and Instruction
CMS-10210 IQR Reconsideration Request Form 5. CMS Quality Reporting Program APU Reconsideration Request Form.pdf Form and Instruction
CMS-10210 IQR Reconsideration Request Form 5. CMS Quality Reporting Program APU Reconsideration Request Form.pdf Form and Instruction
CMS-10210 Validation Review for Reconsideration Request 6. CMS Hospital IQR Program Validation Review for Reconsideration Request Form.pdf Form and Instruction
CMS-10210 Validation Review for Reconsideration Request 6. CMS Hospital IQR Program Validation Review for Reconsideration Request Form.pdf Form and Instruction
CMS-10210 VBP Appeal Request Form 10. Hospital Value-Based Purchasing (VBP) Program Appeal Request Form.pdf Form and Instruction
CMS-10210 VBP Appeal Request Form 10. Hospital Value-Based Purchasing (VBP) Program Appeal Request Form.pdf Form and Instruction
CMS-10210 HVBP CMS Independent Review Form 11. Hospital Value-Based Purchasing (VBP) Program Independent CMS Review Request Form.pdf Form and Instruction
CMS-10210 HVBP CMS Independent Review Form 11. Hospital Value-Based Purchasing (VBP) Program Independent CMS Review Request Form.pdf Form and Instruction
CMS-10210 Validation Educational Review Form 8. CMS Quality Reporting Validation Educational Review Form (1).pdf Form and Instruction
CMS-10210 Validation Educational Review Form 8. CMS Quality Reporting Validation Educational Review Form (1).pdf Form and Instruction
Summary of HQR Information Collection Forms - FY2022 IPPS proposed Rule - HQR PRA Package.docx Summary of Updates on HIQR Collection Forms IC Document
Summary of HQR Information Collection Forms - FY2022 IPPS proposed Rule - HQR PRA Package.docx Summary of Updates on HIQR Collection Forms IC Document