[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