[Federal Register Volume 61, Number 27 (Thursday, February 8, 1996)]
[Notices]
[Pages 4787-4788]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-2649]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Submitted for Collection of Public Comment: Submission for OMB 
Review

    In compliance with the Paperwork Reduction Act (44 U.S.C. 3501 et 
seq.), the Health Care Financing Administration (HCFA), Department of 
Health and Human Services, is announcing that the Information 
Collection Requests (ICR) abstracted below have been forwarded to the 
Office of Management and Budget (OMB) for review and 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: Reinstatement, with 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Peer Review Organization 
(PRO) Reporting Forms; Form Nos.: HCFA 613-627; Use: PROs are 
authorized to review inpatient and outpatient services for quality of 
care provided and to eliminate unreasonable, unnecessary, and 
inappropriate care provided to Medicare beneficiaries. The PROs are 
required to report the results of the review to HCFA. Frequency: 
Monthly, quarterly; Affected Public: Business or other for profit; 
Number of Respondents: 53; Total Annual Hours: 10,759.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Information 
Collection Requirements in HSQ 108-F, Assumption of Responsibilities; 
Form No.: HCFA R-71; Use: Rule establishes the review functions to be 
performed by the PRO and outlines the relationships among PROs, 
providers, practitioners, beneficiaries, fiscal intermediaries, and 
carriers. Frequency: Monthly, quarterly; Affected Public: Business or 
other for profit; Number of Respondents: 53; Total Annual Hours: 
46,653.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medical Records 
Review Under Prospective Payment System (PPS); Form No.: HCFA R-50; 
Use: PROs are authorized to conduct medical review activities under the 
PPS. In order to conduct medical review activities, we depend upon 
hospitals to make available specific records. Frequency: Annually; 
Affected Public: Business or other for profit; Number of Respondents: 
6,412; Total Annual Hours: 22,400.
    4. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Home Health Agency Survey and 
Deficiencies Report, Home Health Functional Assessment Instrument; Form 
Nos.: HCFA-1572, HCFA-1515; Use: In order to participate in the 
Medicare program as a home health agency (HHA) provider, the HHA must 
meet Federal standards. These forms are used to record information 
about patients' health and provider compliance with requirement and 
report information to the Federal Government. Frequency: Annually; 
Affected Public: Business or other for profit; Number of Respondents: 
8,622; Total Annual Hours: 129,330.
    5. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Survey Team Composition and 
Workload Report; Form No.: HCFA-670; Use: This form will provide 
information on resource utilization applicable to survey activity in 
the Medicare/Medicaid provider/supplier types and Clinical Laboratory 
Improvement Amendment (CLIA) laboratories. This information will assist 
HCFA in determining Federal reimbursement for surveys conducted. 
Frequency: Annually; Affected Public: State, local, or tribal 
governments; Number of Respondents: 53; Total Annual Hours: 71,667.
    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 must be sent within 30 days of this notice directly to the 
OMB Desk Officer designated at the 

[[Page 4788]]
following address: OMB Human Resources, and Housing Branch, Attention: 
Allison Eydt, New Executive Office Building, Room 10235, Washington, DC 
20503.

    Dated: February 1, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-2649 Filed 2-7-96; 8:45 am]
BILLING CODE 4120-03-P