[Federal Register Volume 64, Number 76 (Wednesday, April 21, 1999)]
[Page 19544]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-9969]



Health Care Financing Administration
[Document Identifier: HCFA-1728 and HCFA-R-0266]

Agency Information Collection Activities: Submission for OMB 
Review; 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: Home Health 
Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24 
and 413.106; Form No.: HCFA-1728 (OMB No. 0938-0022); Use: 
Participating providers are required to submit annual information to 
HCFA in order to achieve settlement of costs for health care services 
rendered to Medicare beneficiaries. The HCFA-1728 is the form used by 
Home Health Agencies to report their health care costs to determine the 
amount reimbursable for services furnished to Medicare beneficiaries. 
Frequency: Annually; Affected Public: Business or other for profit, Not 
for profit institutions, and State, Local or Tribal Gov.; Number of 
Respondents: 8,950; Total Annual Responses: 8,950; Total Annual Hours 
Requested: 1,575,200.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicaid 
Disproportionate Share Hospital Payments--Institutions for Mental 
Disease; Form No.: HCFA-R-0266 (OMB# 0938-0746); Use: This PRA package 
announces the Federal share of disproportionate share hospital (DSH) 
allotments for Federal fiscal years (FFYs) 1998 through 2002. It also 
describes the methodology for calculating the Federal share DSH 
allotments for FFY 2003 and thereafter, and announces the FFY 1998 and 
FFY 1999 limitations on aggregate DSH payments States may make to 
institutions for mental disease (IMD) and other mental health 
facilities.; Frequency: Annually; Affected Public: State, Local, or 
Tribal Government; Number of Respondents: 54; Total Annual Responses: 
54; Total Annual Hours: 2,160.
    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 30 days of this notice directly to the OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Allison Eydt, New 
Executive Office Building, Room 10235, Washington, D.C. 20503.

    Dated: April 13, 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. 99-9969 Filed 4-20-99; 8:45 am]