[Federal Register Volume 62, Number 33 (Wednesday, February 19, 1997)]
[Notices]
[Pages 7467-7468]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-3985]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-1514]


Agency Information Collection Activities: Proposed Collection; 
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, is 
publishing the following summary of proposed collections for public 
comment. 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.
    Type of Information Collection Request: Extension of currently 
approved collection; Title of Information Collection: Hospital Request 
for Certification in the Medicare/Medicaid Program; Form No.: HCFA-
1514; Use: Section 1861 of the Social Security Act and 42 CFR part 482 
requires hospitals to be certified to participate in the Medicare/
Medicaid program. As part of the certification process, providers must 
complete form HCFA-1514. This certification form is a facility 
identification and screening form used to initiate the certification 
process and to determine if the provider has sufficient personnel to 
participate in the Medicare/Medicaid program. Frequency: Annually; 
Affected Public: State, Local or Tribal Gov't.; Number of Respondents: 
2,500; Total Annual Responses: 2,500; Total Annual Hours: 625.
    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/regs/prdact95.htm, 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

[[Page 7468]]

designated at the following address: HCFA, Office of Financial and 
Human Resources, Management Analysis and Planning Staff, Attention: 
John Rudolph, Room C2-25-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: February 10, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources.
[FR Doc. 97-3985 Filed 2-18-97; 8:45 am]
BILLING CODE 4120-03-M