[Federal Register Volume 61, Number 138 (Wednesday, July 17, 1996)]
[Notices]
[Page 37278]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-18094]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Health Care Financing Administration, HHS.
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 summaries 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.
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Provider/Supplier Enrollment Application; Form No.: HCFA-855; Use: This
information is needed to enroll providers/suppliers by identifying
them, verifying their qualifications and eligibility to participate in
Medicare, and to price and pay their claims; Frequency: Other (Initial
Application/recertification); Affected Public: Business or other for
profit, not for profit institutions, and federal government; Number of
Respondents: 165,000; Total Annual Responses: 165,000; Total Annual
Hours: 370,000.
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 , 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 Planning and Analysis Staff, Attention: John Burke, Room C2-
26-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: July 9, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-18094 Filed 7-16-96; 8:45 am]
BILLING CODE 4120-03-P
