[Federal Register Volume 61, Number 65 (Wednesday, April 3, 1996)]
[Notices]
[Pages 14799-14800]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-8054]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Health Care Financing Administration, HHS.
    In compliance with the Paperwork Reduction Act of 1995 (44 U.S.C. 
3501 et seq.), the Health Care Financing Administration (HCFA), 
Department of Health and Human Services, has submitted to the Office of 
Management and Budget (OMB) the following proposals for the collection 
of information. 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 subject: (1) The necessity 
and utility of 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 
Therapy 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/

[[Page 14800]]

Medicaid Programs, 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 
surveyors 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: 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.
    5. 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.
    6. Galley 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.
    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 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 10235, Washington, D.C. 20503.

    Dated: March 27, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-8054 Filed 4-2-96; 8:45 am]
BILLING CODE 4120-03-P-M