[Federal Register Volume 59, Number 192 (Wednesday, October 5, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-24665]
[[Page Unknown]]
[Federal Register: October 5, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Public Information Collection Requirements Submitted to the
Office of Management and Budget (OMB) for Clearance
AGENCY: Health Care Financing Administration.
The Health Care Financing Administration (HCFA), Department of
Health and Human Services (HHS), has submitted to OMB the following
proposals for the collection of information in compliance with the
Paperwork Reduction Act (Public Law 96-511).
1. Type of Request: Reinstatement; Title of Information Collection:
Indirect Medical Education; Form No.: HCFA-R-64; Use: This collection
of information on interns and residents is needed to calculate Medicare
program payments for hospitals for the indirect costs they incur for
medical education. Frequency: Annually; Respondents: Businesses or
other for profit, nonprofit institutions; Estimated Number of
Responses: 1,250; Average Hours Per Response: 3; Total Estimated Burden
Hours: 3,750.
2. Type of Request: Revision; Title of Information Collection:
Psychiatric Unit Criteria Worksheet, Rehabilitation Hospital Criteria
Worksheet, and Rehabilitation Unit Criteria Worksheet; Form Nos.: HCFA-
437, -437A, -437B; Use: These forms are necessary to verify and
reverify that these facilities/units comply and remain in compliance
with the exclusion criteria for the Medicare prospective payment
system; Frequency: Annually; Respondents: Businesses or other for
profit, nonprofit institutions, and State or local governments;
Estimated Number of Responses: 2,349; Average Hours Per Response: .25;
Total Estimated Burden Hours: 587.
3. Type of Request: Reinstatement; Title of Information Collection:
Medicare Supplier Number Application; Form No.: HCFA-192; Use:
Legislation requires all suppliers to disclose the names of owners and
managing employees. This form establishes a standard for that data
collection. These data are used to identify common ownership and
management and sanctioned individuals in the Medicare and Medicaid
programs; Frequency: On occasion; Respondents: Businesses or other for
profit, small businesses or organizations; Estimated Number of
Responses: 50,000; Average Hours Per Response: .75; Total Estimated
Burden Hours: 37,500.
4. Type of Request: Reinstatement; Title of Information Collection:
Requests for Medicare Payment by Municipal Health Services Program
(MHSP) Clinics; Form No.: HCFA-127; Use: This form allows for the 15
participating clinics to be reimbursed for services they provided to
Medicare beneficiaries. The form permits cities participating in the
MHSP to receive correct and timely reimbursement and expedites the
routing and payment of bills; Frequency: Weekly; Respondents: State or
local governments; Estimated Number of Responses: 443,000; Average
Hours Per Response: .16; Total Estimated Burden Hours: 70,880.
5. Type of Request: New; Title of Information Collection:
Examination and Treatment for Emergency Medical Conditions and Women in
Labor and 42 CFR 489.24 Essentials of Provider Agreement
Responsibilities of Medicare Participating Hospitals in Emergency
Cases; Form No.: HCFA-1514A/B; Use: Under Section 1867 of the Social
Security Act, Examination and Treatment for Emergency Medical
Conditions and Women in Labor, effective August 1986, hospitals may
continue to participate in Medicare only if they are not out of
compliance with its provisions. We need to provide this tool to
surveyors to promote uniform and thorough application of the
requirements and to gather information frequently requested by Congress
and other interested parties regarding implementation of the statute;
Frequency: On occasion; Respondents: Federal agencies or employees,
nonprofit institutions, State or local governments, individuals or
households; Estimated Number of Responses: 350; Average Hours Per
Response: .25; Total Estimated Burden Hours: 87.5.
6. Type of Request: New; Title of Information Collection:
Evaluation of Patient and Physician Satisfaction With the Medicare
Participating Heart Bypass Center Demonstration; Form No. HCFA-R-166;
Use: This requirement provides HCFA with information to determine
whether lowering the amount paid for heart bypass procedures
compromises the care provided to Medicare beneficiaries; Frequency:
One-time survey; Respondents: Individuals or households; Estimated
Number of Responses: 840; Average Hours Per Response: .35; Total
Estimated Burden Hours: 294.
Additional Information or Comments: Call the Reports Clearance
Office on (410) 966-5536 for copies of the clearance request packages.
Written comments and recommendations for the proposed information
collections should be sent within 30 days of this notice directly to
the OMB Desk Officer designated at the following address: OMB Human
Resources and Housing Branch, Attention: Allison Eydt, New Executive
Office Building, Room 3001, Washington, D.C. 20503.
Dated: September 29, 1994.
Kathleen Larson,
Acting Director, Management Planning and Analysis Staff, Office of
Financial and Human Resources, Health Care Financing Administration.
[FR Doc. 94-24665 Filed 10-4-94; 8:45 am]
BILLING CODE 4120-03-P
