[Federal Register Volume 63, Number 219 (Friday, November 13, 1998)]
[Notices]
[Page 63478]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-30429]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-R-257]


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 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 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: Medicare+Choice Disenrollment 
Form.
    Form Nos.: HCFA-R-257 (OMB# 0938-0741).
    Use: The primary purpose of the 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.
    (2) Type of Information Collection Request: Revision of a currently 
approved collection;
    Title of Information Collection: Information Collection 
Requirements in HSQ-108-F Assumption of Responsibilities and Supporting 
Regulations in 42 CFR 412.44, 412.46, 431.630, 456.654, 466.71, 466.73, 
466.74, and 466.78;
    Form No.: HCFA-R-0071 (OMB# 0938-0445);
    Use: This purpose of this collection is to create the Utilization 
and Quality Control Peer Review Organization (PRO) program which 
replaces the Professional Standards Review Organization (PSRO) program 
and streamlines peer review activities. This rule outlines the review 
functions to be performed by the PRO and outlines the relationships 
among PROs, providers, practitioners, beneficiaries, fiscal 
intermediaries, and carriers.
    Frequency: Other, as needed;
    Affected Public: Business or other for-profit;
    Number of Respondents: 53;
    Total Annual Responses: 880;
    Total Annual Hours: 46,653.
    (3) Type of Information Collection Request: Extension of a 
currently approved collection;
    Title of Information Collection: Sole Community Home Health 
Agencies (HHA) and Supporting Regulations in 42 CFR Section 424.22;
    Form No.: HCFA-R-0085 (OMB# 0938-0489);
    Use: These regulations implement the rules for participation of 
HHAs in Medicare and the establishment and review of plans of care for 
home health services. These regulations make it easier for certain HHAs 
to meet certification and plan of care requirements.
    Frequency: Annually;
    Affected Public: Business or other for-profit and not-for-profit 
institutions;
    Number of Respondents: 20;
    Total Annual Responses: 20;
    Total Annual Hours: 40.
    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. 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, Security and Standards Group, Division of HCFA 
Enterprise Standards, Attention: Dawn Willinghan, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: November 15, 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. 98-30429 Filed 11-12-98; 8:45 am]
BILLING CODE 4120-03-P