[Federal Register Volume 61, Number 112 (Monday, June 10, 1996)]
[Notices]
[Pages 29407-29408]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-14478]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[R-10, R-79]


Agency Information Collection Activities: Submission for OMB 
Review; 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, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal 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 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: Information 
Collection Requirements contained in BPD-718: Advance Directives 
(Medicare and Medicaid); Form No.: HCFA-R-10; Use: Certain Medicare and 
Medicaid organizations are responsible for collecting and documenting, 
in medical records, whether or not an individual has executed an 
advance directive. This document indicates the individual's preference 
if he/she is incapacitated. Frequency: On occasion; Affected Public: 
Business or other for-profit, Not-for-profit institutions, Federal 
Government, and State, Local or Tribal Government; Number of 
Respondents: 38,927; Total Annual Responses: 38,927; Total Annual Hours 
Requested: 908,250.
    2. Type of Information Collection Request: Reinstatement, with 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Payment Adjustment for Sole 
Community Hospitals; Form No.: HCFA-R-79; Use: Hospitals designated as 
``Sole Community Hospitals'' that experience a five percent decrease in 
discharges in one cost reporting period, as compared to the previous 
period, due to unusual circumstances, beyond its control, may request 
an adjustment to its Medicare payment amount. Frequency: As desired; 
Affected Public: Business or other for-profit, Not-for-profit 
institutions, and State, Local or Tribal Government; Number of 
Respondents: 40; Total Annual Responses: 40; Total Annual Hours 
Requested: 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.


[[Page 29408]]


    Dated: June 3, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-14478 Filed 6-7-96; 8:45 am]
BILLING CODE 4120-03-P