[Federal Register Volume 62, Number 124 (Friday, June 27, 1997)]
[Notices]
[Page 34761]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-16807]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-R-201 and HCFA 901,1-3]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration, HHS.
    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 summaries of proposed collections for public 
comment. Interested persons are invited to send comments regarding this 
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: Managed Care 
Organization, Incentive Arrangement Disclosure Form and Supporting 
Regulations 42 CFR 417.479, 417.500, 434.44, 434.67, 434.70, 1003.100, 
1003.101, 1003.103, 1003.106; Form No.: HCFA-R-201 (OMB # 0938-0700); 
Use: These forms were created in an extensive cooperative effort with 
the American Association of Health Plans, State Medicaid Agency 
representatives, and the Medicaid Managed Care Technical Advisory group 
to monitor compliance with federal statute and supporting regulations, 
governing physician incentives under Medicare and Medicaid managed care 
organizations. The currently approved forms and the revised forms being 
submitted to OMB for approval are available for inspection on the HCFA 
web site, on the Internet, at http://www.hcfa.gov; Frequency: Annually; 
Affected Public: Business or other for profit, not for profit 
institutions, state, local or tribal government, and federal 
government; Number of Respondents: 450; Total Annual Responses: 450; 
Total Annual Hours: 45,000.
    2.Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Qualification Application for 
Competitive Medical Plan, Medicare Contract Application For Federally 
Qualified Health Maintenance Organization (HMO) and Supporting 
Regulations 42 CFR 417.143, and 417.408; Form No.: HCFA-901,1-3; Use: 
Prepaid health plans must meet certain regulatory requirements which 
are captured in these applications, before they are considered a 
Federally qualified HMO that is eligible for a Medicare Sec. 1876 
contract. Section 1876 of the Social Security Act authorizes 
compensation to eligible organizations either on a reasonable cost or a 
risk basis for services provided under the Medicare program. Frequency: 
one time; Affected Public: Business or other for-profit, Not-for-profit 
institutions, and State, Local or Tribal Government; Number of 
Respondents: 65; Total Annual Responses: 65; Total Annual Hours: 6,500.
    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, 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 Burke, Room C2-
26-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: June 19, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 97-16807 Filed 6-26-97; 8:45 am]
BILLING CODE 4120-03-P