[Federal Register Volume 62, Number 114 (Friday, June 13, 1997)]
[Notices]
[Pages 32358-32359]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-15506]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-255]


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 collection 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 a currently 
approved collection; Title of Information Collection: Municipal Health 
Services Cost Report Form, and supporting regulations 42 CFR 405.427; 
Form No.: HCFA-255; Use: The Municipal Health Services Program (MHSP) 
Cost Report (HCFA-255) is

[[Page 32359]]

used by the participating MHSP clinics to report costs for health care 
services rendered to Medicare beneficiaries. It is also used to gather 
data to properly evaluate the MHSP demonstration. This form has been 
used since 1979. Frequency: Annually; Affected Public: Not-for-profit 
institutions, and State, Local or Tribal Government; Number of 
Respondents: 14; Total Annual Responses: 14; Total Annual Hours: 476.
    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: 
John Rudolph, Room C2-26-17, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: June 5, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources.
[FR Doc. 97-15506 Filed 6-12-97; 8:45 am]
BILLING CODE 4120-03-P