[Federal Register Volume 62, Number 114 (Friday, June 13, 1997)]
[Notices]
[Pages 32358-32359]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-15506]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-255]
Agency Information Collection Activities: Proposed Collection;
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, is
publishing the following summary of proposed collection for public
comment. 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: Extension of a currently
approved collection; Title of Information Collection: Municipal Health
Services Cost Report Form, and supporting regulations 42 CFR 405.427;
Form No.: HCFA-255; Use: The Municipal Health Services Program (MHSP)
Cost Report (HCFA-255) is
[[Page 32359]]
used by the participating MHSP clinics to report costs for health care
services rendered to Medicare beneficiaries. It is also used to gather
data to properly evaluate the MHSP demonstration. This form has been
used since 1979. Frequency: Annually; Affected Public: Not-for-profit
institutions, and State, Local or Tribal Government; Number of
Respondents: 14; Total Annual Responses: 14; Total Annual Hours: 476.
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 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 Analysis and Planning Staff, Attention:
John Rudolph, Room C2-26-17, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: June 5, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial
and Human Resources.
[FR Doc. 97-15506 Filed 6-12-97; 8:45 am]
BILLING CODE 4120-03-P
