[Federal Register Volume 62, Number 19 (Wednesday, January 29, 1997)]
[Notices]
[Pages 4304-4305]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-2088]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Form # HCFA-1500]


Emergency Clearance: Public Information Collection Requirements 
Submitted to the Office of Management and Budget (OMB)

    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 (DHHS), 
has submitted to the Office of Management and Budget (OMB) the 
following request for Emergency review. We are requesting an emergency 
review because the collection of this information is needed prior to 
the expiration of the normal time limits under OMB's regulations at 5 
CFR, Part 1320, in order to prevent providers from denying services to 
beneficiaries. The Agency cannot reasonably comply with the normal 
clearance procedures because public harm is likely to result if normal 
clearance procedures are followed. Without this information, HCFA would 
not be able to process claims possibly resulting in the denial of 
services to

[[Page 4305]]

Medicare Beneficiaries, due to provider non-payment.
    HCFA is requesting that OMB provide a seven working day review and 
a 180-day approval. During this 180-day period HCFA will pursue OMB 
clearance of this collection as stipulated by 5 CFR 1320.5.
    1. Type of Information Collection Request: Reinstatement without 
change, of a previously approved collection; Title of Information 
Collection: Medicare/Medicaid Health Insurance Common Claim Form and 
Instructions, and Supporting Regulations 42 CFR 424.32 (Basic 
Requirements for all Claims) and 42 CFR 414.40 (Coding and Ancillary 
Policies); Form No.: HCFA-1500; Use: This form and instructions are 
standardized for use in the Medicare/Medicaid programs to apply for 
reimbursement for covered services. HCFA does not require exclusive use 
of this form for Medicaid. 42 CFR 424.32 and 42 CFR 414.40 are 
regulations underlying the use of the form HCFA-1500 and the 
information captured on the form HCFA-1500, including the use of 
diagnostic and procedural coding systems; Frequency: On occasion; 
Affected Public: Business or other for profit, not for profit 
institutions, State, local or tribal government; Number of Respondents: 
976,239; Total Annual Responses: 614,967,982; Total Annual Hours: 
52,139,385.
    To request copies of the proposed paperwork collections referenced 
above, call the Reports Clearance Office on (410) 786-1325. Written 
comments and recommendations for the proposed information collections 
should be sent within five working 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: January 23, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 97-2088 Filed 1-28-97; 8:45 am]
BILLING CODE 4120-03-P