[Federal Register Volume 62, Number 67 (Tuesday, April 8, 1997)]
[Notices]
[Page 16863]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-8949]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-643]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
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 technology to minimize the information collection
burden.
Type of Information Collection Request: Reinstatement, without
change, of previously approved collection for which approval has
expired; Title of Information Collection: Hospice Survey and
Deficiencies Report Form and Supporting Regulations 42 CFR Sections
488,488.26(c), 442.30(a)(4), 442, Subpart B, C, D, E and F; Form No.:
HCFA-643; Use: The survey report form and supporting regulations are
needed to ensure provider compliance with Medicare and Medicaid
conditions of participation. In order to participate in the Medicare
program, a hospice must meet certain Federal health and safety
conditions of participation. The survey report form will be used by
State surveyors to record data about a hospice's compliance with
Federal health and safety conditions in order to initiate the
certification or recertification process. Frequency: Annually; Affected
Public: State, Local or Tribal Govt, Federal Govt; Number of
Respondents: 2,150; Total Annual Responses: 2,150; Total Annual Hours:
5,375.
To obtain copies of the supporting statement for the proposed
paperwork collections referenced above, access HCFA's WEB SITE ADDRESS
at http://www.hcfa.gov/regs/prdact95.htm, 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 30 days of this notice directly to the HCFA Paperwork Clearance
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: March 26, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 97-8949 Filed 4-7-97; 8:45 am]
BILLING CODE 4120-03-P
