Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC) (CMS-10769)

Forms and Documents

Document Name	Status
Form CMS-10769 HQIC Hospital Survey Form and Instruction	New
Form CMS-10769 NQIIC Nursing Home Survey Form and Instruction	New
CMS-10769_Crosswalk_for_30_Day_Package_Changes_v4_508.pdf Supplementary Document	2021-07-02
CMS-10769_Response_to_Comments_Received_2021-06-07.docx Supplementary Document	2021-07-02
CMS-10769_Sup_Statement_Part_B 6-7-21.docx Supporting Statement B	2021-07-02
Supporting_Statement_A_7.06.21.docx Supporting Statement A	2021-07-06

IC Document Collections

IC ID	Document Title	Status
248181	HQIC Hospital Survey Form and Instruction	New
248179	NQIIC Nursing Home Survey Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202107-0938-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC) (CMS-10769)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/06/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,000	0
Time Burden (Hours)	330	0
Cost Burden (Dollars)	0	0

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Abstract: The purpose of this Information Collection Request (ICR) is to conduct two surveys as part of the evaluation of the Centers for Medicare & Medicaid Services (CMS) Network of Quality Improvement and Innovation Contractors (NQIIC). This ICR focuses on data collection to assess satisfaction and use of program resources among nursing homes through contracts with Quality Innovation Network-Quality Improvement Organizations (QIN-QIO) and in hospitals through contracts with Hospital Quality Improvement Contractors (HQICs). The surveys will target administrators for nursing homes and hospitals demonstrating a range of participation in order to evaluate the effect of the program on quality improvement efforts. As required by Sections 1152-1154 of the Social Security Act, CMS directs the QIN-QIO Program, one of the largest federal programs dedicated to improving healthcare quality for Medicare beneficiaries. QIOs help Medicare providers with quality improvement throughout the spectrum of care, including with review of quality concerns for the protection of beneficiaries and the Medicare Trust Fund. This program is a key component of the U.S. Department of Health and Human Services' National Quality Strategy and the CMS Quality Strategy, with the overarching goals to achieve better health care and better health, and to lower the costs of care.

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Authorizing Statute(s): US Code: 42 USC 1320c-1 Name of Law: Social Security Act
   PL: Pub.L. 112 - 40 261 Name of Law: Social Security Act
  

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:
	86 FR 13566	03/09/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 35300	07/02/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
HQIC Hospital Survey	CMS-10769	HQIIC Hospital Survey
NQIIC Nursing Home Survey	CMS-10769	NQIIC Nursing Home Survey

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ICR Summary of Burden

	Total Request	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	1,000	0	0	1,000	0	0
Annual Time Burden (Hours)	330	0	0	330	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden increased from an estimated total of 300 hours to a total of 330 hours after pretests found both surveys averaged 20 minutes.

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Annual Cost to Federal Government: $443,253

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? No

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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: 07/06/2021

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