[Federal Register Volume 63, Number 123 (Friday, June 26, 1998)]
[Notices]
[Page 34904]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-16999]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-R-243]


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: New Collection; Title of 
Information Collection: Medicare Agreement Application, Health Care 
Prepayment Plan; Form No.: HCFA-R-243; Use: An organization must meet 
certain requirements to be a Health Care Prepayment Plan that is 
eligible for a Medicare 1833 agreement. The application is the 
collection form used to obtain information from an organization that 
would allow HCFA staff to determine compliance with the regulations. 
This form includes requests for information about: the management of 
the applicant organization; arrangements for providing health care to 
beneficiaries; meeting Medicare requirements for appeals, hearings, 
advance directives, health benefits; risk sharing with other entities; 
the fiscal soundness of the applicant; the cost budget, which forms the 
basis for HCFA payment; prevention of duplicate payment; and the 
applicant's marketing strategy. Frequency: One time ; Affected Public: 
Business or other for-profit institutions, Not-for-profit institutions, 
and State, Local or Tribal Governments.; Number of Respondents: 15; 
Total Annual Responses: 15; Total Annual Hours: 1,125.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, or 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 Information Services, Information Technology 
Investment Management Group, Division of HCFA Enterprise Standards, 
Attention: John Rudolph, Room C2-26-17, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.

    Dated: June 18, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, Division of HCFA Enterprise Standards, 
Health Care Financing Administration.
[FR Doc. 98-16999 Filed 6-25-98; 8:45 am]
BILLING CODE 4120-03-P