Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)

Forms and Documents

Document Name	Status
Form CMS-10432 Inpatient Psychiatric Facility Quality Reporting Program Form and Instruction	Modified
CMS-10432 IPFQR Supporting Statement A (4-24-17).docx Supporting Statement A	2017-05-09

IC Document Collections

IC ID	Document Title	Status
202349	Inpatient Psychiatric Facility Quality Reporting Program Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1171	ICR Reference No: 201705-0938-005
Status: Historical Inactive	Previous ICR Reference No: 201608-0938-016
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 07/27/2017
	Date Received in OIRA: 05/19/2017
Terms of Clearance: OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a new OMB Control Number, the OMB Control Number will not appear in the active inventory. For future submissions of this information collection, reference the OMB Control Number provided. OMB is withholding approval at this time. Prior to publication of the final rule, the agency should provide a summary of any comments related to the information collection and their response, including any changes made to the ICR as a result of comments. In addition, the agency must enter the correct burden estimates

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	36 Months From Approved	07/31/2019
Responses	1,428,032	0	1,428,032
Time Burden (Hours)	4,657,944	0	4,657,944
Cost Burden (Dollars)	0	0	0

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Abstract: Section 10322 of the Affordable Care Act (ACA) authorizes the establishment of a new quality reporting program for Inpatient Psychiatric Facilities (IPFs). The program began with an initial set of 6 measures for FY 2014 and FY 2015 and currently includes 18 measures. For FY 2020 we propose adding one measure calculated from administrative claims. IPFs that fail to comply with the program’s requirements will receive a 2% reduction in their Annual Payment Update (APU). To minimize burden and maximize efficiency, CMS has leveraged existing systems within CMS to collect aggregated data and calculated measure rates from the IPFs, in a form, manner and time as specified by CMS, via a secure portal known as the QualityNet Web site. CMS will use the FY 2014 procedural requirements designed to align with current quality reporting programs. These procedural requirements involve submitting necessary forms (e.g., Notice of Participation Form, Reconsideration Request Form) to comply with the program and align with current CMS reporting requirements for other hospital quality reporting programs. When adding new measures, the law requires CMS, where “feasible and practical”, to select measures put forward by “one or more national consensus building entities”. Section 3013 of the ACA requires CMS to perform a gap analysis for needed quality measures every three years. Section 3014 of the ACA requires CMS to develop quality and efficiency measures through a “consensus-based entity”. Consequently, the Measure Applications Partnership (MAP), convened by the National Quality Forum (NQF), was formed to develop measures consistent with these requirements. CMS reviewed the MAP’s formal recommendations prior to identifying IPFQR measures for the FY 2018 IPPS/LTCH PPS rule.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 10322 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS98	Proposed rulemaking	82 FR 19796	04/28/2017

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Federal Register Notices & Comments

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
Inpatient Psychiatric Facility Quality Reporting Program	CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432, CMS-10432	IPF Data Accuracy Form ,   HBIPS Measures Data Collection Tool ,   Vendor Authorization Form ,   Online Data Entry Tool Content for Structural Measures ,   FY 2019 Non-Measure Data Collection Paper Tool ,   IPF Screen shots ,   Notice of Participation ,   Online Data Entry Tool Content for Web-Based Measure Collection ,   TOB IMM Collection Form ,   Transitions Measures Collection Form ,   Substance Use Measure Collection

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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:

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Annual Cost to Federal Government: $106,839

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]? 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: 05/19/2017

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