[Federal Register Volume 63, Number 251 (Thursday, December 31, 1998)]
[Notices]
[Pages 72317-72318]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-34665]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-R-10 & HCFA-1513]
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: Extension of a
currently approved collection;
Title of Information Collection: Information Collection
Requirements Contained in BDP-718: Advanced Directives (Medicare and
Medicaid) and Supporting Regulations in 42 CFR Sections 417.436, .801,
430.12, .20, 431.107, 434.28, 483.10, 484.10, 489.102;
Form No.: HCFA-R-10 (OMB# 0938-0610);
Use: Certain Medicare and Medicaid organizations are responsible
for collecting and documenting, in medical records, whether or not an
individual has executed an advanced directive. This document indicates
the individual's preference if he/she is incapacitated;
Frequency: On occasion;
Affected Public: Business or other for-profit, Not-for-profit
institutions, Federal Government, and State, Local or Tribal
Government;
Number of Respondents: 35,607;
Total Annual Responses: 35,607;
Total Annual Hours: 908,250.
(2) Type of Information Collection Request: Extension of a
currently approved collection;
Title of Information Collection: Medicare/Medicaid Disclosure of
Ownership and Control Interest Statement and Supporting Regulations in
42 CFR Sections 420.200-.206, 455.100-.106;
Form No.: HCFA-1513 (OMB# 0938-0086);
Use: The Medicare/Medicaid Disclosure of Ownership and Control
Interest Statement must be used by State agencies and HCFA regional
offices to determine whether providers meet the eligibility
requirements for Titles 18 and 19 (Medicare and Medicaid) and for
grants under Titles V and XX. Review of ownership and control is
particularly necessary to prohibit ownership and control for
individuals excluded under Federal fraud statutes.;
Frequency: Other (every 1 to 3 years);
Affected Public: Business or other for-profit, and Not-for-profit
institutions;
Number of Respondents: 125,000;
Total Annual Responses: 125,000;
Total Annual Hours: 62,500.
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
[[Page 72318]]
of HCFA Enterprise Standards, Attention: Dawn Willinghan, Room N2-14-
26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: December 21, 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. 98-34665 Filed 12-30-98; 8:45 am]
BILLING CODE 4120-03-P
