[Federal Register Volume 62, Number 54 (Thursday, March 20, 1997)]
[Notices]
[Page 13389]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-7085]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA 1728 and HCFA 9049]
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.
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Home Health
Agency Cost Report; Form No.: HCFA-1728; Use: The HCFA 1728 is the form
used by Home Health Agencies to report their health care costs to
determine the amount reimbursable for services furnished to Medicare
beneficiaries. Frequency: Annually; Affected Public: Business or other
for profit, Not for profit institutions, and State, Local or Tribal
Gov.; Number of Respondents: 8,950; Total Annual Hours: 1,575,200.
2. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Information on Provider
Refunds--HCFA 9049, 42 CFR 489.40-41; Form No.: HCFA-9049; Use: When a
Medicare claim is denied and then paid as a result of a
reconsideration, there is a possibility that the provider has already
been paid by the beneficiary. These questions on provider refunds will
be used on intermediary forms to verify that the provider has refunded
the beneficiary's money. Frequency: On occasion; Affected Public:
Business or other for profit; Number of Respondents: 4,236; Total
Annual Hours: 1,059.
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 designated at the following address: HCFA, Office of Financial
and Human Resources, Management Analysis and Planning Staff, Attention:
Louis Blank, Room C2-26-17, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: March 13, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial
and Human Resources.
[FR Doc. 97-7085 Filed 3-19-97; 8:45 am]
BILLING CODE 4120-03-P