[Federal Register Volume 61, Number 16 (Wednesday, January 24, 1996)]
[Notices]
[Pages 1940-1941]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-910]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

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 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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: End Stage Renal 
Disease Medical Evidence Report Medicare Entitlement and/or Patient 
Registration; Form No.: HCFA-2728; Use: This form captures the 
necessary medical information required to determine Medicare 
eligibility of an end stage renal disease claimant. It also captures 
the specific medical data required for research and policy decisions on 
this population as required by law. Frequency: Annually; Affected 
Public: Individuals or households, business or other for-profit, not-
for-profit institutions; Number of Respondents: 60,000; Total Annual 
Hours Requested: 25,200.
    To request copies of the proposed paperwork collections referenced 
above, 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: Louis Blank, Room C2-26-17, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.


[[Page 1941]]

    Dated: January 16, 1996
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources.
[FR Doc. 96-910 Filed 1-23-96; 8:45 am]
BILLING CODE 4120-03-P