[Federal Register Volume 64, Number 23 (Thursday, February 4, 1999)]
[Notices]
[Pages 5665-5666]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-2646]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-R-257 & HCFA-R-71]
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, has
submitted to the Office of Management and Budget (OMB) the following
proposal for the collection of information. Interested persons are
invited to send comments regarding the 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
[[Page 5666]]
technology to minimize the information collection burden.
(1) Type of Information Collection Request: Extension of a
currently approved collection;
Title of Information Collection: Medicare+Choice Disenrollment Form
to original Medicare;
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: On occasion;
Affected Public: Individuals or Households, Business or other for-
profit, Not-for-profit institutions, and Federal Government;
Number of Respondents: 60,000;
Total Annual Responses: 60,000;
Total Annual Hours: 3,960.
(2) Type of Information Collection Request: Extension of a
currently approved collection;
Title of Information Collection: Information Collection
Requirements in HSQ-108F Assumption of Responsibilities and Supporting
Regulations in 42 CFR 412.44, 412.46, 431.630, 466.71, 466.73, 466.74,
and 466.78;
Form Nos.: HCFA-R-71 (OMB# 0938-0445);
Use: The 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: 6,471;
Total Annual Responses: 6,418;
Total Annual Hours: 46,834.
To request copies of the proposed paperwork collections referenced
above, E-mail your request, including your address, to
Paperwork@hcfa.gov, or call the Reports Clearance Office on (410) 786-
1326. 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 10235, Washington, D.C. 20503.
Dated: January 13, 1999.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services,
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 99-2646 Filed 2-3-99; 8:45 am]
BILLING CODE 4120-03-P
