[Federal Register Volume 63, Number 180 (Thursday, September 17, 1998)]
[Notices]
[Pages 49701-49702]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-24934]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier HCFA-R-257]


Emergency Clearance: Public Information Collection Requirements 
Submitted to the Office of Management and Budget (OMB)

    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 (DHHS), 
is publishing the following summary 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 of the 
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.
    We are, however, requesting an emergency review of the information 
collection referenced below. In compliance with the requirement of 
section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have 
submitted to the Office of Management and Budget (OMB) the following 
requirements for emergency review. Due to the unanticipated event and 
the fact that this collection of this information is needed before the 
expiration of the normal time limits under OMB's regulations at 5 CFR 
part 1320, we are requesting an emergency review.
    With the creation of the Medicare+Choice program, as required by 
the Balanced Budget Act of 1997 (Pub. L. 105-33), new provisions have 
been implemented to coordinate Medicare beneficiaries' choices through 
the Medicare+Choice organizations. Specifically, the provisions require 
the establishment of procedures through which Medicare+Choice elections 
are made and changed, including the form and manner in which such 
elections are made and changed, as required by section 4001 of the 
Balanced Budget Act (BBA) of 1997. This necessitated a need to create 
an additional mechanism for beneficiaries make election to disenroll to 
original Medicare. This also provided the opportunity to collect 
information on beneficiary disenrollment behavior, as the BBA 
provisions required the development of quality and performance 
measures, specifically including collection of information regarding 
disenrollment rates. Collection of disenrollment reason data will 
promote active, informed selection by beneficiaries of options as well 
as to conduct quality control studies. By allowing beneficiaries the 
ability to request the disenrollment forms from the customer 
teleservice representatives, HCFA will ultimately be providing the 
beneficiary with more flexibility and options.
    The purpose of this submission is to request approval of a 
disenrollment form that beneficiaries will be able to obtain from the 
Medicare+Choice toll-free number that is to be established (as required 
by the BBA). Such a form allows the beneficiary to disenroll from a 
Medicare+Choice organization to original (fee-for-service) Medicare and 
allows HCFA to collect information for analysis of disenrollment rates 
and reasons for disenrollment. The Medicare+Choice toll-free number 
will be operational in November 1998 and a more expedient review is 
needed in order for the form to be ready to provide to the 
beneficiaries when the call center is operational.
    HCFA is requesting OMB review and approval of this collection 
within eleven working days, with a 180-day approval period. Written 
comments and recommendations will be accepted from the public if 
received by the individual designated below, within ten working days of 
publication of this notice in the Federal Register.
    During this 180-day period, HCFA will pursue OMB clearance of this 
collection as stipulated by 5 CFR 1320.
    Type of Information Collection Request: New Collection.
    Title of Information Collection: Medicare+Choice Disenrollment 
Form.
     Form Nos.: HCFA-R-257.
    Use: The primary purpose of the new form is to receive and process 
the beneficiary's request for disenrollment from a Medicare+Choice plan 
and to return to original (fee-for-service) Medicare. The secondary 
purpose of the new form is to obtain the reason for the disenrollment, 
for analysis and reporting.
    Frequency: As requested by beneficiary.
    Affected Public: Individuals or households, Business or other for-
profit, Not-for-profit institutions, and Federal government.
    Number of Respondents: 60,000 annually.
    Total Annual Responses: 20,000 in first year, 60,000 thereafter.
    Total Annual Hours: 3,960.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access HCFA's 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and 
HCFA document identifier, to P[email protected], or call the Reports 
Clearance Office on (410) 786-1326.
    Interested persons are invited to send comments regarding the 
burden or any other aspect of these collections of information 
requirements. However, as noted above, comments on these information 
collection and record keeping requirements must be mailed and/or faxed 
to the designee referenced below, within ten working days of

[[Page 49702]]

publication of this collection in the Federal Register:

Health Care Financing Administration, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards, 
Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850, Fax 
Number: (410) 786-0262, Attn: Louis Blank HCFA-R-257
    and
Office of Information and Regulatory Affairs, Office of Management and 
Budget, Room 10235, New Executive Office Building, Washington, DC 
20503, Fax Number: (202) 395-6974 or (202) 395-5167, Attn: Allison 
Herron Eydt, HCFA Desk Officer.

    Dated: September 10, 1998.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 98-24934 Filed 9-16-98; 8:45 am]
BILLING CODE 4120-03-P