[Federal Register Volume 64, Number 55 (Tuesday, March 23, 1999)]
[Notices]
[Pages 13997-13998]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-6968]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-R-10 & HCFA-1513]


Agency Information Collection Activities: Submission for OMB 
Review; 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, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal for the collection of information. 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.
    (1) Type of Information Collection Request: Extension of a 
currently approved collection;
    Title of Information Collection: Information Collection 
Requirements Contained in BDP-718: Advanced Directives (Medicare and 
Medicaid) and Supporting Regulations in 42 CFR 417.436, 417.801, 
422.128, 430.12, 431.20, 431.107, 434.28, 483.10, 484.10, 489.102;
    Form No.: HCFA-R-10 (OMB# 0938-0610);
    Use: Certain Medicare and Medicaid organizations are responsible 
for collecting and documenting, in medical records, whether or not an 
individual has executed an advanced directive. This document indicates 
the individual's preference if he/she is incapacitated;
    Frequency: On occasion;
    Affected Public: Business or other for-profit, Not-for-profit 
institutions, Federal Government, and State, Local or Tribal 
Government;
    Number of Respondents: 35,905;
    Total Annual Responses: 35,905;
    Total Annual Hours: 908,250.
    (2) Type of Information Collection Request: Extension of a 
currently approved collection;
    Title of Information Collection: Disclosure of Ownership and 
Financial Control Interest Statement and

[[Page 13998]]

Supporting Regulations in 42 CFR 420.200-420.206, 455.100-455.106;
    Form No.: HCFA-1513 (OMB# 0938-0086);
    Use: The Medicare/Medicaid Disclosure of Ownership and Control 
Interest Statement must be used by State agencies and HCFA regional 
offices to determine whether providers meet the eligibility 
requirements for Titles 18 and 19 (Medicare and Medicaid) and for 
grants under Titles V and XX. Review of ownership and control is 
particularly necessary to prohibit ownership and control for 
individuals excluded under Federal fraud statutes;
    Frequency: Other (every 1 to 3 years);
    Affected Public: Business or other for-profit, and Not-for-profit 
institutions;
    Number of Respondents: 125,000;
    Total Annual Responses: 125,000;
    Total Annual Hours: 62,500.
    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/regs/prdact95.htm, or 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 30 days of this notice directly to the OMB Desk Officer 
designated at the following address:

OMB Human Resources and Housing Branch, Attention: Allison Eydt, New 
Executive Office Building, Room 10235, Washington, D.C. 20503.

    Dated: February 25, 1999.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 99-6968 Filed 3-22-99; 8:45 am]
BILLING CODE 4120-03-P