[Federal Register Volume 60, Number 240 (Thursday, December 14, 1995)]
[Notices]
[Pages 64167-64168]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-30474]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Information Collection Requirements Submitted for Public
Comment and Recommendations
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
[[Page 64168]]
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. Type of Information Collection Request: New collection; Title of
Information Collection: Maximizing the Effectiveness of Home Health
Care: The Influence of Service Volume and Integration With Other Care
Settings on Patient Outcomes; Form No.: HCFA-R-189; Use: This study
will examine (1) the relationship of home health care service volume
and patient outcomes, and (2) the relationship of the physician role
and integration of other services and patient outcomes; Frequency:
Other (periodically); Affected Public: Not-for-profit institutions,
business or other for profit, and individuals or households; Number of
Respondents: 6,300; Total Annual Hours: 3,573.
2. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Request for Certification in
the Medicare and/or Medicaid Program to Provide Outpatient Physical
Therepy and/or Speech Pathology Services, Outpatient Physical Therapy
Speech Pathology Survey Report; Form Nos.: HCFA-1856, HCFA-1893; Use:
The Medicare Program requires outpatient physical therapy providers to
meet certain health and safety requirements. The request for
certification form is used by State agency surveyors to determine if
minimum Medicare eligibility requirements are met. The survey report
form records the result of the onsite survey; Frequency: On occasion;
Affected Public: Business or other for profit; Number of Respondents:
1,700; Total Annual Hours: 446.25.
3. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Request for Certification as
Supplier of Portable X-ray Services Under the Medicare/Medicaid
Programs, and Portable X-ray Survey Report; Form Nos.: HCFA-1880, HCFA-
1882; Use: The Medicare program requires portable x-ray suppliers to be
surveyed for health and safety standards. The HCFA-1882 is the survey
form that records survey results. The HCFA-1880 is used by the surveyor
to determine if a portable x-ray applicant meets the eligibility
requirements; Frequency: On occasion; Affected Public: Business or
other for profit; Number of Respondents: 520; Total Annual Hours: 137.
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Organ Procurement
Organization's Request for Designation; Form No.: HCFA-576; Use: The
information provided on this form serves as a basis for certifying
organ procurement organizations (OPO) for participation in the Medicare
and Medicaid programs and will indicate whether the OPO is meeting the
specified performance standards for reimbursement of service;
Frequency: Biennially; Affected Public: Business or other for profit,
not-for-profit institutions; Number of Respondents: 80; Total Annual
Hours: 160.
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Physical
Therapist in Independent Practice Request for Certification in the
Medicare Program; Form No.: HCFA-262; Use: The HCFA-262 is used by the
surveyors to determine if a physical therapist in independent practice
requesting Medicare approval meets the eligibility requirements;
Frequency: On occasion; Affected Public: Business or other for profit;
Number of Respondents: 7,322; Total Annual Hours: 1,098.
6. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Request for
Approval as a Hospital Provider of Extended Care Services (Swing-Bed)
in the Medicare and Medicaid Programs; Form No.: HCFA-605; Use: The
HCFA-605 is used for facility identification and screening. It will be
completed by a hospital that is requesting approval and will initiate
the process of determining the hospital's eligibility and for which bed
count category the hospital wishes to request approval; Frequency:
Other (one-time usage for initial application); Affected Public:
Business or other for profit, not-for-profit institutions, Federal
Government; Number of Respondents: 1,500; Total Annual Hours: 375.
To request copies of the proposed paperwork collections referenced
above, E-mail your request, including your address, to
P[email protected], or 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: December 7, 1995.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 95-30474 Filed 12-13-95; 8:45 am]
BILLING CODE 4120-03-P