[Federal Register Volume 61, Number 40 (Wednesday, February 28, 1996)]
[Notices]
[Page 7522]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-4534]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Public Information Collection Requirements Submitted for Public
Comment and Recommendations
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 summaries 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: Reinstatement, without
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Medicare and Medicaid
Disclosure of Ownership and Control Interest Statement; Form No.: HCFA-
1513; Use: The information provided on this form is 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 5 and 20. Review of ownership and
control is particularly necessary to prohibit ownership and control for
individuals excluded under Federal Fraud statutes; Frequency: On
Occasion; Affected Public: Business or other for profit, not-for-
profit; Number of Respondents: 60,000; Total Annual Hours: 30,000.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Evaluation of the
Program of All-Inclusive Care for the Elderly (PACE) Demonstration;
Form No.: HCFA-R-165; Use: This survey will collect data on functional
status, service utility, and out-of-pocket costs, and satisfaction for
a sample of applicants to the PACE program. This information will be to
analyze the decision to participate in PACE and the impact of the
program; Frequency: Semi-annually; Affected Public: Individuals and
households; Number of Respondents: 1,833; Total Annual Hours: 3,745.
To obtain copies of the supporting statement for the proposed
paperwork collections referenced above, access HCFA's WEB SITE ADDRESS
at http://www.ssa.gov/hcfa/hcfahp2.html , or to obtain the supporting
statement and any related forms, E-mail your request, including your
address and phone number, 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 Financial
and Human Resources, Management Planning and Analysis Staff, Attention:
John Burke, Room C2-26-17, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Dated: February 16, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-4534 Filed 2-27-96; 8:45 am]
BILLING CODE 4120-03-P
