04-7927. Agency Information Collection Activities: Proposed Collection; Comment Request

AGENCY:

Office of the Secretary, HHS.

In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), 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.

Type of Information Collection Request: Revision of a Currently Approved Collection.

Title of Information Collection: OCR Pre-grant Data Request Package.

Form/OMB No.: OS-0990-0243.

Use: Health care providers who have requested certification to participate in the Medicare program must review their policies/practices and submit documents to demonstrate compliance with the civil rights requirements of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973 and the Age Discrimination Act of 1975.

Frequency: Recordkeeping, Single time.

Affected Public: Business or other for profit; state, local or tribal government.

Annual Number of Respondents: 4,000.

Total Annual Responses: 4,000.

Average Burden Per Response: 16 hours.

Total Annual Hours: 64,000.

To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access the HHS Web site address at http://www.hhs.gov/​oirm/​ infocollect/pending/ or e-mail your request, including your address, phone number, OMB number, and OS document identifier, to [e-mail], or call the Reports Clearance Office on [phone]. Written comments and recommendations for the proposed information collections must be mailed within 30 days of this notice directly to the OMB Desk Officer at the address below: OMB Desk Officer: Brenda Aguilar, OMB Human Resources and Housing Branch, Attention: (OMB #0990-0243), New Executive Office Building, Room 10235, Washington, DC 20503.

Dated: March 30, 2004.

Robert E. Polson,

Office of the Secretary, Paperwork Reduction Act Reports Clearance Officer.