[Federal Register Volume 61, Number 94 (Tuesday, May 14, 1996)]
[Notices]
[Pages 24310-24311]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11997]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[R-193, R-44, R-194]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    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 summary 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: Existing collection in 
use without an OMB control number; Title of Information Collection: An 
Important Message from Medicare; Form No.: HCFA R-193; Use: Hospitals 
participating in the Medicare program have agreed to distribute ``An 
Important message from Medicare'' to each beneficiary for each 
admission. Recordkeeping: As needed; Affected Public: Individuals or 
Households, Business or other for-profit; Not-for-profit institutions, 
Federal Government, and State, Local or Tribal Government; Number of 
Respondents: 6,700; Total Annual Responses: 11,000,000; Total Annual 
Hours Requested: 183,333.
    2. Type of Information Collection Request: Reinstatement, with 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Title Conditions of 
Participation for Rehabilitation Agencies and Conditions for Coverage 
for Physical Therapists in Independent Practice; Form No.: HCFA R-44; 
Use:

[[Page 24311]]

This information is needed to determine if an agency or therapist is in 
compliance with published health and safety requirements. Respondents 
are outpatient clinics, rehabilitation agencies, public health 
agencies, and therapists in independent practice. Frequency: On 
occasion; Affected Public: Business or other for-profit; Number of 
Respondents: 9,634; Total Annual Responses: 9,634; Total Annual Hours 
Requested: 26,397.
    3. Type of Information Collection Request: New collection; Title of 
Information Collection: Medicare Disproportionate Share Adjustment 
Procedure and Criteria; Form No.: HCFA R-194; Use: Regulation sets up 
an alternative process for hospitals that choose to have their 
disproportionate share adjustment statistics calculated based on their 
cost reporting periods rather than the Federal fiscal year. Frequency: 
On occasion; Affected Public: Business or other for-profit, and Not-
for-profit institutions; Number of Respondents: 100; Total Annual 
Responses: 100; Total Annual Hours Requested: 100.
    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 Office 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.

    Dated: May 7, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources.
[FR Doc. 96-11997 Filed 5-13-96; 8:45 am]
BILLING CODE 4120-03-P