[Federal Register Volume 62, Number 163 (Friday, August 22, 1997)]
[Notices]
[Page 44701]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-22343]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-255]
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.
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 405.371;
Form No.: HCFA-255; Use: The Municipal Health Services Program (MHSP)
Cost Report (HCFA-255) is 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 30 days of this notice directly to the HCFA Paperwork Clearance
Officer designated at the following address: OMB Human Resources and
Housing Branch, Attention: Allison Eydt, New Executive Office Building,
Room 10235, Washington, DC 20503.
Dated: August 8, 1997.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services,
Information Technology Investment Management Group, Division of HCFA
Enterprise Standards.
[FR Doc. 97-22343 Filed 8-21-97; 8:45 am]
BILLING CODE 4120-03-P
