[Federal Register Volume 61, Number 112 (Monday, June 10, 1996)]
[Notices]
[Pages 29407-29408]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-14478]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[R-10, R-79]
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.
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Information
Collection Requirements contained in BPD-718: Advance Directives
(Medicare and Medicaid); Form No.: HCFA-R-10; Use: Certain Medicare and
Medicaid organizations are responsible for collecting and documenting,
in medical records, whether or not an individual has executed an
advance directive. This document indicates the individual's preference
if he/she is incapacitated. Frequency: On occasion; Affected Public:
Business or other for-profit, Not-for-profit institutions, Federal
Government, and State, Local or Tribal Government; Number of
Respondents: 38,927; Total Annual Responses: 38,927; Total Annual Hours
Requested: 908,250.
2. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Payment Adjustment for Sole
Community Hospitals; Form No.: HCFA-R-79; Use: Hospitals designated as
``Sole Community Hospitals'' that experience a five percent decrease in
discharges in one cost reporting period, as compared to the previous
period, due to unusual circumstances, beyond its control, may request
an adjustment to its Medicare payment amount. Frequency: As desired;
Affected Public: Business or other for-profit, Not-for-profit
institutions, and State, Local or Tribal Government; Number of
Respondents: 40; Total Annual Responses: 40; Total Annual Hours
Requested: 160.
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.
[[Page 29408]]
Dated: June 3, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-14478 Filed 6-7-96; 8:45 am]
BILLING CODE 4120-03-P
