[Federal Register Volume 63, Number 146 (Thursday, July 30, 1998)]
[Notices]
[Page 40723]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-20406]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-R-243]
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 collections 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: New Collection; Title of
Information Collection: Medicare Agreement Application, Health Care
Prepayment Plan; Form No.: HCFA-R-243; Use: An organization must meet
certain requirements to be a Health Care Prepayment Plan that is
eligible for a Medicare 1833 agreement. The application is the
collection form used to obtain information from an organization that
would allow HCFA staff to determine compliance with the regulations.
This form includes requests for information about: the management of
the applicant organization; arrangements for providing health care to
beneficiaries; meeting Medicare requirements for appeals, hearings,
advance directives, health benefits; risk sharing with other entities;
the fiscal soundness of the applicant; the cost budget, which forms the
basis for HCFA payment; prevention of duplicate payment; and the
applicant's marketing strategy. Frequency: One time; Affected Public:
Business or other for-profit institutions, Not-for-profit institutions,
and State, Local or Tribal Governments.; Number of Respondents: 15;
Total Annual Responses: 15; Total Annual Hours: 1,125.
To obtain copies of the supporting statement for the proposed
paperwork collections referenced above, or 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 Information Services, Information Technology
Investment Management Group, Division of HCFA Enterprise Standards,
Attention: John Rudolph, Room C2-26-17, 7500 Security Boulevard,
Baltimore, Maryland 21244-1850.
Dated: July 23, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, Division of HCFA Enterprise Standards,
Health Care Financing Administration.
[FR Doc. 98-20406 Filed 7-29-98; 8:45 am]
BILLING CODE 4120-03-P
