Notice2025-18266
Agency Information Collection Activities: Proposed Collection: Public Comment Request; Information Collection Request Title: Medicare Rural Hospital Flexibility Program Performance, OMB No. 0915-0363-Revision
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 22, 2025
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
In compliance with the Paperwork Reduction Act of 1995, HRSA submitted an Information Collection Request (ICR) to the Office of Management and Budget (OMB) for review and approval. Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public during the review and approval period. OMB may act on HRSA's ICR only after the 30-day comment period for this notice has closed.
Full Text
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<title>Federal Register, Volume 90 Issue 181 (Monday, September 22, 2025)</title>
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[Federal Register Volume 90, Number 181 (Monday, September 22, 2025)]
[Notices]
[Pages 45388-45390]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-18266]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Public Comment Request; Information Collection Request Title: Medicare
Rural Hospital Flexibility Program Performance, OMB No. 0915-0363--
Revision
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA
submitted an Information Collection Request (ICR) to the Office of
Management and Budget (OMB) for review and approval. Comments submitted
during the first public review of this ICR will be provided to OMB. OMB
will accept further comments from the public during the review and
approval period. OMB may act on HRSA's ICR only after the 30-day
comment period for this notice has closed.
DATES: Comments on this ICR should be received no later than October
22, 2025.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent
[[Page 45389]]
within 30 days of publication of this notice to: <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular information collection by
selecting ``Currently under Review--Open for Public Comments'' or by
using the search function.
FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance
requests submitted to OMB for review, email Samantha Miller, the HRSA
Information Collection Clearance Officer, at <a href="/cdn-cgi/l/email-protection#136372637661647c6178537b6160723d747c65"><span class="__cf_email__" data-cfemail="423223322730352d3029022a3031236c252d34">[email protected]</span></a> or call
(301) 443-3983.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title: Medicare Rural Hospital
Flexibility Program Performance, OMB No. 0915-0363--Revision.
Abstract: The mission of the Federal Office of Rural Health Policy
(FORHP) within HRSA is to sustain and improve access to quality health
care services for rural communities. FORHP administers the Medicare
Rural Hospital Flexibility Program (Flex Program) authorized by Section
1820(g) of the Social Security Act (42 U.S.C. 1395i-4(g)). The Flex
Program enables state designated entities to support critical access
hospitals in quality improvement, quality reporting, performance
improvement, and benchmarking; to assist facilities seeking designation
as critical access hospitals; and to create a program to establish or
expand the provision of rural emergency medical services. HRSA
currently collects information from grant recipients that participate
in the Flex Program using an OMB-approved set of performance measures,
the Medicare Rural Hospital Flexibility Program Performance Measures,
and seeks to revise its approved information collection. HRSA is
proposing significant changes to the method by which performance
measures are collected, the organization of the measures, and the
measures themselves. More detail is provided in the ``Need and Proposed
Use of the Information'' section below.
A 60-day Notice was published in the Federal Register on November
6, 2024, vol. 89, No. 215; pp. 88053-55. A total of three comments were
received. The comments and HRSA's responses are described below.
Need and Proposed Use of the Information: For this program,
performance measures were developed to provide data useful to program
administration, to benefit Flex Program recipients, and to enable HRSA
to provide aggregate program data required by Congress under the
Government Performance and Results Modernization Act of 2010. These
measures cover principal topic areas of interest to FORHP, including:
(a) quality reporting, (b) quality improvement interventions, (c)
financial and operational improvement initiatives, (d) population
health management, and (e) rural emergency medical services
integration. In addition to informing HRSA's progress toward meeting
the goals set in the Government Performance and Results Modernization
Act, the information is important in identifying and understanding
programmatic improvement across program areas, as well as guiding
future activities and prioritizing areas of need and support.
Performance measures are collected electronically in the
Performance Improvement and Measurement System (PIMS), which awardees
currently access through the HRSA Electronic Handbooks, a data
collection platform. As part of a broader change affecting all programs
across FORHP, HRSA proposes to change the method of PIMS report
submission from the Electronic Handbooks to a different electronic data
collection platform. In addition, HRSA proposes to reduce the total
number of forms submitted. The current collection involves eight forms,
and HRSA proposes reducing this to six forms: one for recipients to
select which program areas they are working in and one for each program
area selected. One commenter noted the difficulty in reporting their
annual spending. This feedback was incorporated into the new electronic
data collection platform and that specific form will be removed and
instead, the spending will be reported elsewhere without the specific
problems of the coding background.
Performance measures in PIMS currently are organized by a series of
checkboxes, where a state entity selects which hospitals are
participating in a funded intervention and if that hospital has shown
improvement after that intervention. HRSA proposes to change the
organization of the measures to align with a format similar to a work
plan submission, which is an existing requirement recipients must meet.
Instead of the series of checkboxes used in the current collection,
HRSA is proposing a series of dropdown menus where respondents can
choose more specific information. One commenter noted that the change
to dropdown menus to align more closely with the work plan would lead
to a better reporting system. They noted that the current system of a
series of checkboxes does not provide enough detail into what the
program is currently doing and increases challenges in reporting, as
errors are more likely to occur.
Finally, HRSA proposes revisions to performance measures in PIMS
that include changes to align with current terminology used by HRSA, a
broadening scope for some activities, and providing examples of more
specific measures. Dropdown menus would contain lists of both common
projects completed across the Flex Program and common outcome measures
associated with each project. Respondents would not be required to
collect all of the measures listed, rather they would be able to choose
from a list of examples. One commenter noted that dropdown menus could
be more effective if they were organized by program topic or funding
area, rather than by hospital, and they should also include an option
of ``other.'' HRSA's proposed changes to the data collection platform
would organize the dropdown menus by program topic and would contain
skip logic, meaning only an outcome measure related to the specific
program topic would be allowed to be chosen, and all dropdowns would
include an option for ``other.''
With these changes, HRSA estimates the burden on the recipients
would decrease. Even though HRSA is proposing to include more specific
performance measures in PIMS reporting, the additional measures reflect
data the recipients are currently collecting in outside forms and
spreadsheets. The current reporting system requires recipients to move
between multiple forms and spreadsheets outside of the PIMS system and
enter the information manually. The new system reduces duplication and
manual data entry by allowing recipients to update their work plans,
which are already in PIMS, with outcome data following the end of the
year. One commenter noted that making the data collection directly
reflective of the work plan could reduce the administrative burden of
tracking measures that may not be related to their work plan. The same
commenter also noted the preference to use the data collection platform
to report their required work plan, which HRSA intends to do as part of
this new collection.
Likely Respondents: Respondents are the Flex Program recipients.
There are currently 45 states participating in the Flex Program.
Burden Statement: Burden in this context means the time expended by
persons to generate, maintain, retain, disclose, or provide the
information requested. This includes the time needed to review
instructions; to develop, acquire, install, and utilize technology and
systems for the purpose
[[Page 45390]]
of collecting, validating, and verifying information, processing and
maintaining information, and disclosing and providing information; to
train personnel and to be able to respond to a collection of
information; to search data sources; to complete and review the
collection of information; and to transmit or otherwise disclose the
information. The total annual burden hours estimated for this ICR are
summarized in the table below.
Following comments received after the publication of the 60-day
notice, HRSA decreased the average burden per response and total burden
hours. Burden will be reduced by consolidating information into
Salesforce, rather than entities needing to maintain data in multiple
locations to report back to FORHP.
Total Estimated Annualized Burden Hours:
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Average
Number of Number of Total burden per Total
Form name respondents responses per responses response burden
respondent (in hours) hours
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Performance Improvement Measurement System. 45 1 45 55 2,475
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Total.................................. 45 .............. 45 ........... 2,475
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Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2025-18266 Filed 9-19-25; 8:45 am]
BILLING CODE 4165-15-P
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