[Federal Register Volume 61, Number 125 (Thursday, June 27, 1996)]
[Notices]
[Pages 33532-33533]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-16440]


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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 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, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Information Collection 
requirements in Final Peer Review Organization Sanction Regulations 42 
CFR 1004.40(b), 1004.50(g), 1004.60(b), and 1004.70(b) and (c); Form 
No.: HCFA-R-65; Use:

[[Page 33533]]

This rule revises and updates the procedures governing the imposition 
and adjudication of program sanctions predicated on recommendations of 
State Utilization and Quality Control Peer Review Organizations (PROs). 
These changes are being made as a result of statutory revisions 
designed to address health care fraud and abuse issues and the Office 
of Inspector General sanction process; Frequency: On Occasion; Affected 
Public: Business or other for profit; Number of Respondents: 53; Total 
Annual Hours: 22,684.
    2. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Post-Certification Revisit 
Form; Form No.: HCFA-2567B; Use: This form is used to collect 
deficiency correction status information pursuant to the Clinical 
Laboratory Improvement Amendments of 1988 and the Medicare/Medicaid 
certification requirements of P.L.100-578 and sections 1864 and 1902 of 
the Social Security Act; Frequency: Annually; Affected Public: Business 
or other for profit, State, Local, or Tribal Governments; Number of 
Respondents: 72,000; Total Annual Hours: 61,000.
    3. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: State Survey Agency List of 
Positions and Schedule of Equipment Purchases; Form No.: HCFA-1465, 
HCFA-1466; Use: The information collected is used by HCFA to determine 
the types of equipment being purchased and the need for such equipment, 
the information also provides HCFA with the types and skill levels of 
surveyor positions that are being requested by the State; Frequency: 
Annually; Affected Public: State, local, and tribal government; Number 
of Respondents: 53; Total Annual Hours: 239.
    4. Type of Information Collection Request: New Collection; Title of 
Information Collection: Granting and Withdrawal of Deeming Authority to 
National Accreditation Organizations; Form No.: HCFA-R-191; Use: The 
information collected is used by HCFA to determine whether a private 
accreditation organization's criteria for granting accreditation is 
equal to or more stringent than the criteria used by Medicare to 
determine Ambulatory Surgical Center eligibility for participation in 
the Medicare Program; Frequency: Other (initial application, as 
needed); Affected Public: Not for profit institutions; Number of 
Respondents: 2; Total Annual Hours: 192.
    5. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Attending Physicians 
Statement and Documentation Of Medical Emergency; Form No.: HCFA-1771; 
Use: This form is used to document the attending physician's statement 
that the hospitalization was required due to an emergency and give 
support for the claim; Frequency: On occasion; Affected Public: 
Business or other for profit; Number of Respondents: 1,700; Total 
Annual Responses: 1,700; Total Annual Hours 425.
    6. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Video Display Terminal (VDT) 
Operators Eye Care Program; Form No.: HCFA-81; Use: This form is needed 
to document gather information necessary to process employees' request 
to participate in the VDT Operators' Eye Care Program. Part of the form 
will be completed by HCFA employees and their supervisors. Another part 
of the form is completed by personal eye care practitioners and 
opticians providing services to HCFA employees; Frequency: On occasion; 
Affected Public: Business or other for profit, individuals or 
households, Federal Government; Number of Respondents: 500; Total 
Annual Responses: 500; Total Annual Hours 2,000.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, access HCFA's WEB SITE ADDRESS 
at http://www.hcfa.gov, or to obtain the supporting statement and any 
related forms, E-mail your request, including your address and phone 
number, 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, DC 20503.

    Dated: June 20, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-16440 Filed 6-26-96; 8:45 am]
BILLING CODE 4120-03-P