[Federal Register Volume 64, Number 144 (Wednesday, July 28, 1999)]
[Notices]
[Page 40888]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-19210]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-R-0273]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration.
    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.
    Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Community Mental 
Health Center Site Visit Assessment Tool and Supporting Regulations in 
42 CFR 410.2; Form No.: HCFA-R-0273 (OMB# 0938-0770); Use: This 
information collection tool is essential for the Health Care Financing 
Administration (HCFA) to ensure that existing Community Mental Health 
Centers (CMHC), as well as CMHC applicants to the Medicare program are 
incompliance with Medicare provider requirements, as well as all 
applicable Federal and State requirements. The collection tool will be 
completed and used by HCFA and or its contractors to collect patient 
records, other CMHC operational information, and to verify CMHC 
compliance as determined by the HCFA regional office. CMHCs will be 
required to sign the completed form, provide medical records, and other 
operational information to be copied by the HCFA contractor 
representative on-site at the CMHC during the site visit.; Frequency: 
Upon initial application or re-enrollment into the Medicare program; 
Affected Public: Business or other for profit, Not for profit 
institutions, and State, Local, or Tribal Government; Number of 
Respondents: 850; Total Annual Responses: 850; Total Annual Hours: 
3,400.
    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: Louis Blank, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: July 19, 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. 99-19210 Filed 7-27-99; 8:45 am]
BILLING CODE 4120-03-P