[Federal Register Volume 59, Number 115 (Thursday, June 16, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-14675]


[[Page Unknown]]

[Federal Register: June 16, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration

 

Public Information Collection Requirements Submitted to the 
Office of Management and Budget (OMB) for Clearance

AGENCY: Health Care Financing Administration, HHS.
    The Health Care Financing Administration (HCFA), Department of 
Health and Human Services (HHS), has submitted to OMB the following 
proposals for the collection of information in compliance with the 
Paperwork Reduction Act (Pub. L. 96-511).
    1. Type of Request: New; Title of Information Collection: 
Evaluation of Medicare SELECT Amendments; Form No.: HCFA-R-164; Use: 
This is a telephone survey of Medicare beneficiaries in six states, 
some of whom have purchased Medicare SELECT policies. There is also a 
mail survey of non-SELECT Medigap insurers in the 15 States where 
Medicare SELECT policies may be sold; Frequency: One time data 
collection; Respondents: Businesses or other for-profit; Estimated 
Number of Responses: 10,288; Average Hours Per Response: 15 minutes 
(telephone interview) 30 minutes (questionnaire); Total Estimated 
Burden Hours: 4035.
    2. Type of Request: Revision; Title of Information Collection: 
Hospital and Hospital Health Care Complex Cost Report; Form No.: HCFA-
2552; Use: This form is used by Hospital Health Care Complexes to 
report their Health Care costs to determine amounts reimbursable for 
the services furnished to Medicare Beneficiaries; Frequency: Annually; 
Respondents: Businesses or other for-profit, Nonprofit institutions, 
Small businesses or organizations; Estimated Number of Responses: 
380,560; Average Hours Per Response: 1 hr; Total Estimated Burden 
Hours: 380,560 (reporting) 4,053,000 (recordkeeping) 4,433,560.
    Additional Information or Comments: Call the Reports Clearance 
Office on (410) 966-5536 for copies of the clearance request packages. 
Written comments and recommendations for the proposed information 
collections should be sent within 30 days of this notice directly to 
the OMB Desk Officer designated at the following address: OMB Human 
Resources and Housing Branch, Attention: Allison Eydt, New Executive 
Office Building, Room 3001, Washington, DC 20503.

    Dated: June 10, 1994.
John A. Streb,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 94-14675 Filed 6-15-94; 8:45 am]
BILLING CODE 4120-03-P