[Federal Register Volume 61, Number 174 (Friday, September 6, 1996)]
[Notices]
[Page 47131]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-22718]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-1964]
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. HCFA-1964 Type of Information Collection Request: Reinstatement,
without change, of previously approved collection for which approval
has expired; Title of Information Collection: Request for Review of
Part B Medicare Claim and Supporting regulation 42 CFR 405.807; Form
No.: HCFA-1964; Use: This form is completed by beneficiaries,
representative, or assignees who wish to pursue their statutory appeal
rights by requesting a review of an initial determination made by a
Part B carrier on a claim for medical and other health services. 42 CFR
405.807 is the regulation supporting this collection of information;
Frequency: On occasion; Affected Public: Individuals or households, not
for profit institutions; Number of Respondents: 7,200,000; Total Annual
Responses: 7,200,000; Total Annual Hours: 1,800,000.
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: August 28, 1996.
Edwin J. Glatzel,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-22718 Filed 9-5-96; 8:45 am]
BILLING CODE 4120-03-P
