ICR Req's in HSQ-110, Acquisition, Protection and Disclosure of PRO Information and Supporting Regulations in 42 CFR 480.104, 480.105, 480.116, 480.134

Forms and Documents

Document Name	Status
Crosswalk HHS 110-Acquisition , Disclosure of QIOs.doc Supplementary Document	2013-08-14
CMS-R-70-Supporting Statement (2013).doc Supporting Statement A	2013-08-14

IC Document Collections

IC ID	Document Title	Status
43656	ICR Req's in HSQ-110, Acquisition, Protection and Disclosure of PRO Information and Supporting Regulations in 42 CFR 476.104, 476.105, 476.116, 476.134	Modified

ICR Details

OMB Control No: 0938-0426	ICR Reference No: 201308-0938-020
Status: Historical Active	Previous ICR Reference No: 200908-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No: 20311
Title: ICR Req's in HSQ-110, Acquisition, Protection and Disclosure of PRO Information and Supporting Regulations in 42 CFR 480.104, 480.105, 480.116, 480.134
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: 09/20/2013
	Date Received in OIRA: 08/15/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved
Responses	5,228	0	0
Time Burden (Hours)	60,660	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Peer Review Improvement Act of 1982 authorizes quality improvement organizations (QIOs), formerly known as PROs, to acquire information necessary to fulfill their duties and functions and places limits on disclosure of the information. These requirements are on the QIOs to provide notices to the affected parties when disclosing information about them. These reqirements serve to protect the rights of the affected parties.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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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:
	78 FR 27400	05/10/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 44569	07/24/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
ICR Req's in HSQ-110, Acquisition, Protection and Disclosure of PRO Information and Supporting Regulations in 42 CFR 476.104, 476.105, 476.116, 476.134

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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	5,228	0	0	0	1,499	3,729
Annual Time Burden (Hours)	60,660	0	0	0	-259	60,919
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: To protect the rights of individuals and providers, QIOs will give a notice to providers and/or individuals, which will contains a description of the type of data QIOs will be collecting, maintaining, and disclosing about them. The QIO will also give the title and address of the QIO employee whom is responsible for maintenance of this data so that the individual or provider will know whom to contact at the QIO. This requirement ensures that the public will be fully informed about the type of information the QIO maintains on them.

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Annual Cost to Federal Government: $954,788

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? 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

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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: 08/15/2013

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