[Federal Register Volume 62, Number 44 (Thursday, March 6, 1997)]
[Notices]
[Pages 10285-10286]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-5532]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-3427]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Health Care Financing Administration.
    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.
    Type of Information Collection Request: Reinstatement, with change, 
of previously approved collection for which approval has expired; Title 
of Information Collection: End Stage Renal Disease (ESRD) Application 
and Survey and Certification Report Form; Form No.: HCFA-3427; Use: 
This form is a facility identification and screening measurement tool 
used to initiate the certification and recertification of ESRD

[[Page 10286]]

facilities. The form is also completed by the Medicare/Medicaid State 
survey agency to determine facility compliance with ESRD conditions for 
coverage; Frequency: Annually; Affected Public: State, Local or Tribal 
Governments; Number of Respondents: 2,640; Total Annual Responses: 
1,056; Total Annual Hours: 2,376.
    To obtain copies of 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, Atten: Allison Eydt, New Executive Office 
Building, Room 10235, Washington, D.C. 20503.

    Dated: February 27, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 97-5532 Filed 3-5-97; 8:45 am]
BILLING CODE 4120-03-M