[Federal Register Volume 61, Number 150 (Friday, August 2, 1996)]
[Notices]
[Pages 40422-40423]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-19629]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Health Care Financing Administration, HHS.
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 summaries of proposed collections for public
comment. Interested persons are invited to send comments regarding this
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 previously approved collection for which approval has
expired; Title of Information Collection: Ambulatory Surgical Center
(ASC) Request for Certification and Survey Report and Supporting
Regulation 42 CFR 416; Form No.: HCFA-377, HCFA-378; Use: The HCFA-377
is the application used an ASC wanting to participate in the Medicare
program. The HCFA-378 is the survey form used by State survey agencies
to determine ASC compliance with individual conditions of coverage. 42
CFR 416 is the regulation supporting the data collected on the HCFA-377
and HCFA-378; Frequency: Annually; Affected Public: State, local, or
tribal governments, business or other for-profit, not-for-profit
institutions; Number of Respondents: 1,900; Total Annual Responses:
1,900; Total Annual Hours: 475.
2. Type of Information Collection Request: Reinstatement, without
change, of previously approved collection for which approval has
expired; Title of Information Collection: Medigap Complaint Database
and Supporting Regulation 42 CFR 403.210 (b); Form No.: HCFA-R-156;
Use: The Medigap database is maintained by the National Association of
Insurance Commissioners, which in turn, sends the Medigap-relevant data
to HCFA. The information is used to monitor State handling of Medigap
related complaints; Frequency: Quarterly; Affected Public: Business or
other for-profit; Number of Respondents: 1; Total Annual Responses: 4;
Total Annual Hours: 160.
3. Type of Information Collection Request: Reinstatement, without
change, of previously approved collection for which approval has
expired; Title of Information Collection: Provider Overpayment Report
and Supporting Regulations 42 CFR 405.370, 405.374, 405.376; Form No.:
HCFA-481; Use: This report is completed daily by Medicare
intermediaries and submitted to HCFA. It lists provider overpayment
information and shows whether or not an intermediary is taking prompt
and aggressive action to recover such overpayments, in accordance with
applicable laws and regulations; Frequency: Daily; Affected Public:
Federal government, business or other for-profit, not-for-profit
institutions; Number of Respondents: 61; Total Annual Responses:
36,600; Total Annual Hours: 3,300.
4. Type of Information Collection Request: New collection; Title of
Information Collection: Hospital Standard for Potentially HIV
Infectious Blood and Blood Products Information Collection Requirements
Contained in 42 CFR 482.27 (c)(2), (c)(4), (c)(7) ; Form No.: HCFA-R-
190; Use: Hospitals must establish policies/procedures and document
patient notification efforts if they have administered potentially HIV
infectious blood and blood products.
[[Page 40423]]
Frequency: On occasion; Affected Public: Business or other for-profit
and not-for-profit institutions; Number of Respondents: 16; Total
Annual Responses: 16; Total Annual Hours Requested: 16.
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 must be mailed within 60 days of this notice
directly to the HCFA Paperwork Clearance Officer designated at the
following address: HCFA, Office of Financial and Human Resources,
Management Planning and Analysis Staff, Attention: John Burke, Room C2-
26-17.
Dated: July 24, 1996.
Edwin J. Glatzel,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-19629 Filed 8-1-96; 8:45 am]
BILLING CODE 4120-03-P