[Federal Register Volume 63, Number 219 (Friday, November 13, 1998)]
[Notices]
[Page 63478]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-30429]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-R-257]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Health Care Financing Administration, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Health Care Financing
Administration (HCFA), Department of Health and Human Services, is
publishing the following summary of proposed collections for public
comment. Interested persons are invited to send comments regarding this
burden estimate or any other aspect of this collection of information,
including any of the following subjects: (1) The necessity and utility
of the proposed information collection for the proper performance of
the agency's functions; (2) the accuracy of the estimated burden; (3)
ways to enhance the quality, utility, and clarity of the information to
be collected; and (4) the use of automated collection techniques or
other forms of information technology to minimize the information
collection burden.
(1) Type of Information Collection Request: Revision of a currently
approved collection;
Title of Information Collection: Medicare+Choice Disenrollment
Form.
Form Nos.: HCFA-R-257 (OMB# 0938-0741).
Use: The primary purpose of the form is to receive and process the
beneficiary's request for disenrollment from a Medicare+Choice plan and
to return to original (fee-for-service) Medicare. The secondary purpose
of the new form is to obtain the reason for the disenrollment, for
analysis and reporting.
Frequency: As requested by beneficiary;
Affected Public: Individuals or households, Business or other for-
profit, Not-for-profit institutions, and Federal government;
Number of Respondents: 60,000 annually;
Total Annual Responses: 20,000 in first year, 60,000 thereafter;
Total Annual Hours: 3,960.
(2) Type of Information Collection Request: Revision of a currently
approved collection;
Title of Information Collection: Information Collection
Requirements in HSQ-108-F Assumption of Responsibilities and Supporting
Regulations in 42 CFR 412.44, 412.46, 431.630, 456.654, 466.71, 466.73,
466.74, and 466.78;
Form No.: HCFA-R-0071 (OMB# 0938-0445);
Use: This purpose of this collection is to create the Utilization
and Quality Control Peer Review Organization (PRO) program which
replaces the Professional Standards Review Organization (PSRO) program
and streamlines peer review activities. This rule outlines the review
functions to be performed by the PRO and outlines the relationships
among PROs, providers, practitioners, beneficiaries, fiscal
intermediaries, and carriers.
Frequency: Other, as needed;
Affected Public: Business or other for-profit;
Number of Respondents: 53;
Total Annual Responses: 880;
Total Annual Hours: 46,653.
(3) Type of Information Collection Request: Extension of a
currently approved collection;
Title of Information Collection: Sole Community Home Health
Agencies (HHA) and Supporting Regulations in 42 CFR Section 424.22;
Form No.: HCFA-R-0085 (OMB# 0938-0489);
Use: These regulations implement the rules for participation of
HHAs in Medicare and the establishment and review of plans of care for
home health services. These regulations make it easier for certain HHAs
to meet certification and plan of care requirements.
Frequency: Annually;
Affected Public: Business or other for-profit and not-for-profit
institutions;
Number of Respondents: 20;
Total Annual Responses: 20;
Total Annual Hours: 40.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access HCFA's
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail
your request, including your address, phone number, OMB number, and
HCFA document identifier, to Paperwork@hcfa.gov, or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 60 days of this notice directly to the HCFA Paperwork Clearance
Officer designated at the following address: HCFA, Office of
Information Services, Security and Standards Group, Division of HCFA
Enterprise Standards, Attention: Dawn Willinghan, Room N2-14-26, 7500
Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: November 15, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services,
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 98-30429 Filed 11-12-98; 8:45 am]
BILLING CODE 4120-03-P
