[Federal Register Volume 60, Number 148 (Wednesday, August 2, 1995)]
[Notices]
[Pages 39403-39404]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-18942]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Public Information Collection Requirements Submitted for Public
Comment and Recommendations
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 (HHS),
is publishing the following summaries of proposed collections for
public comment.
1. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Peer Review Organization
(PRO) Reporting Forms; Form Nos.: HCFA 613-627; Use: PROs are
authorized to review inpatient and outpatient services for quality of
care provided and to eliminate unreasonable, unnecessary, and
inappropriate care provided to Medicare beneficiaries. The PROs are
required to report the results of the review to HCFA. Frequency:
Monthly, quarterly; Affected Public: Business or other for profit;
Number of Respondents: 53; Total Annual Hours: 10,759.
2. Type of Information Collection Request: New Collection; Title of
Information Collection: Evaluation of the Oregon Medicaid Reform
Demonstration, Baseline Survey; Form No.: HCFA R-179; Use: The baseline
survey is one component in the evaluation of the Oregon Medicaid Reform
Demonstration (OMRD), a demonstration authorized under section 115 of
the Social Security Act. The purpose of the survey is to gather
information on the health status, past utilization, and level of
satisfaction of a sample of newly enrolled OMRD recipients, in a way
that allows followup contact, and maximizes the likelihood of
preenrollment recall. Frequency: Annually; Affected Public: Individuals
or households; Number of Respondents: 2,667; Total Annual Hours: 500.
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Information
Collection Requirements in HSQ 108-F, Assumption of Responsibilities;
Form No.: HCFA R-71; Use: Rule establishes the review functions to be
performed by the PRO and outlines the relationships among PROs,
providers, practitioners, beneficiaries, fiscal intermediaries, and
carriers. Frequency: Monthly, quarterly; Affected Public: Business or
other for profit; Number of Respondents: 53; Total Annual Hours:
46,653.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medical Records
Review Under Prospective Payment System (PPS); Form No.: HCFA R-50;
Use: PROs are authorized to conduct medical review activities under the
PPS. In order to conduct medical review activities, we depend upon
hospitals to make available specific records. Frequency: Annually;
Affected Public: Business or other for profit; Number of Respondents:
6,412; Total Annual Hours: 22,400.
5. Type of Information Collection Request: New Collection; Title of
Information Collection: Evaluation of the Medicare Cataract Surgery
Alternate Payment Demonstration; Form No.: HCFA-R-177; Use: To test the
feasibility of a negotiated bundled payment for the entire episode of
cataract surgery with an intraocular lens implant and, provide insight
into appropriateness indicators and effective quality assurance and
utilization review mechanisms for cataract surgery. Frequency:
Annually; Affected Public: Business or other for profit institutions;
Number of Respondents: 1,686; Total Annual Hours: 506.
6. Type of Information Collection Request: Reinstatement, without
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Home Health Agency Survey and
Deficiencies Report, Home Health Functional Assessment Instrument; Form
Nos.: HCFA-1572, HCFA-1515; Use: In order to participate in the
Medicare program as a home health agency (HHA) provider, the HHA must
meet Federal standards. These forms are used to record information
about patients' health and provider compliance with requirement and
report information to the Federal Government. Frequency: Annually;
Affected Public: Business or other for profit; Number of Respondents:
8,622; Total Annual Hours: 129,330.
7. Type of Information Collection Request: Reinstatement, without
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Survey Team Composition and
Workload Report; Form No.: HCFA-670; Use: This form will provide
information on resource utilization applicable to survey activity in
the Medicare/Medicaid provider/supplier types and Clinical Laboratory
Improvement Amendment (CLIA) laboratories. This information will assist
HCFA in determining Federal reimbursement for surveys conducted.
Frequency: Annually; Affected Public: State, local, or tribal
governments; Number of Respondents: 53; Total Annual Hours: 71,667.
8. Type of Information Collection Request: New collection; Title of
Information Collection: Field Testing of the Uniform Needs Assessment
Instrument; Form No.: HCFA-R-180; Use: The validity, reliability, and
administrative feasibility of the Uniform Needs Assessment instrument
will be
[[Page 39404]]
tested in a small-scale trial. Also, a high risk screener will be
developed to identify hospital patients in need of extensive discharge
planning. Testing will be done in two phases approximately 1 year
apart. Each phase will involve 12 provider sites, 420 patients, and 840
total assessments. Frequency: Annually; Affected Public: Individuals or
households, business or other for profit, and not-for-profit
institutions; Number of Respondents: 420; Total Annual Hours: 1,050.
To request copies of the proposed paperwork collections referenced
above, call the Reports Clearance Office on (410) 786-1326. Written
comments and recommendations for the proposed information collections
should be sent 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 24, 1995.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 95-18942 Filed 8-1-95; 8:45 am]
BILLING CODE 4120-03-P
