[Federal Register Volume 59, Number 198 (Friday, October 14, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-25455]


[[Page Unknown]]

[Federal Register: October 14, 1994]


-----------------------------------------------------------------------

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 for expedited review 
in compliance with the Paperwork Reduction Act (Pub. L. 96-511).
    1. Type of Request: Revision; Title of Information Collection: End 
Stage Renal Disease Medical Evidence Report - Medicare Entitlement and/
or Patient Registration; Form No.: HCFA-2728; Use: This data collection 
captures the specific medical information required to determine the 
Medicare eligibility of an end stage renal disease claimant. It also 
collects data for research and policy decisions on this population; 
Frequency: On occasion; Respondents: Businesses or other for profit, 
individuals or households, small businesses or organizations; Estimated 
Number of Responses: 60,000; Average Hours Per Response: .42; Total 
Estimated Burden Hours: 25,200.
    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, D.C. 20503.

    Dated: October 6, 1994.
Kathleen Larson,
Acting Director, Management Planning and Analysis Staff, Office of 
Financial and Human Resources, Health Care Financing Administration.

BILLING CODE 4120-03-P

TN14OC94.002


TN14OC94.003


TN14OC94.004


TN14OC94.005


TN14OC94.006


TN14OC94.007

[FR Doc. 94-25455 Filed 10-13-94; 8:45 am]
BILLING CODE 4120-03-C