[Federal Register Volume 61, Number 56 (Thursday, March 21, 1996)]
[Notices]
[Page 11647]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-6757]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency Information Collection Activities; Proposed Collection;
Comment Request
AGENCY: Health Care Financing Administration, HHS.
In compliance with the Paperwork Reduction Act (44 U.S.C. 3501 et
seq.) this notice is publishing the following summaries of proposed
collections for public comment. The title, description, and respondent
description of the information collection are shown below with an
estimate of the annual reporting and recordkeeping burden. Included in
the estimate is the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. 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: Video Display
Terminal (VDT) Operators Eye Care Program; Form No.: HCFA-81; Use: This
form is needed to gather information necessary to process employees'
request to participate in the VDT Operators' Eye Care Program. Part of
the form will be completed by HCFA employees and their supervisors.
Another part of the form is completed by personal eye care
practitioners and opticians providing services to HCFA employees;
Frequency: On occasion; Affected Public: Business or other for profit,
Individuals or households, Federal Government; Number of Respondents:
500; Total Annual Responses: 500; Total Annual Hours Requested 2,000.
2. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Attending Physicians
Statement and Documentation of Medical Emergency; Form No.: HCFA-1771;
Use: This form is used to document the attending physician's statement
that the hospitalization was required due to an emergency and give
clinical support for the claim; Frequency: On occasion; Affected
Public: Business or other for profit; Number of Respondents: 1,700;
Total Annual Responses: 1,700; Total Annual Hours Requested 425.
To request copies of the proposed paperwork collection referenced
above, call the Reports Clearance Office on (410) 786-1326. Written
comments and recommendations for the proposed information collections
should be sent 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: Zaneta Davis, 7500 Security Boulevard, Room
C2-26-17 Baltimore, Maryland 21244-1850.
Dated: March 14, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff.
[FR Doc. 96-6757 Filed 3-20-96; 8:45 am]
BILLING CODE 4120-03-P
