[Federal Register Volume 65, Number 52 (Thursday, March 16, 2000)]
[Notices]
[Pages 14324-14325]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-6538]


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RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

SUMMARY: In accordance with the requirement of Section 3506 (c)(2)(A) 
of the Paperwork Reduction Act of 1995, which provides opportunity for 
public comment on new or revised data collections, the Railroad 
Retirement Board (RRB) publishes periodic summaries of proposed data 
collections.
    Comments are invited on: (a) Whether the proposed information 
collection is necessary for the proper performance of the functions of 
the agency, including whether the information has practical utility; 
(b) the accuracy of the RRB's estimate of the burden of the collection 
of the information; (c) ways to enhance the quality, utility,and 
clarity of the information to be collected; and (d) ways to minimize 
the burden related to the collection of information on respondents, 
including the use of automated collection techniques or other forms of 
information technology.
    Title and purpose of information collection: Application for 
Hospital Insurance Benefits; OMB 3220-0082. Under Section 7(d) of the 
Railroad Retirement Act (RRA), the Railroad Retirement Board (RRB) 
administers the Medicare program for persons covered by the railroad 
retirement system. The RRB currently uses Form AA-6, Employee 
Application for Medicare; Form AA-7, Spouse/Divorced Spouse Application 
For Medicare; and Form AA-8, Widow/Widower Application for Medicare; to 
obtain the information needed to determine whether individuals who have 
not yet filed for benefits under the RRA are qualified for Medicare 
payments provided under Title XVIII of the Social Security Act. 
Completion is required to obtain a benefit. One response is requested 
of each respondent. The RRB proposes minor editorial changes to Forms 
AA-6, AA-7 and AA-8. The RRB estimates that 180 Form AA-6's, 50 Form 
AA-7's, and 10 Form AA-8's are completed annually. The completion time 
for each form is estimated at 8 minutes.
    The renewal of this information collection will begin the RRB's 
initiative to consolidate information collections by major functional 
areas. The purpose of the initiative is to bring related collection 
instruments together in one collection, better manage the instruments, 
and prepare for the electronic collection of this information. (A 
collection instrument can be an individual form, electronic collection, 
interview, or any other method that collects specific information from 
the public.)
    As part of the OMB renewal process, the RRB also proposes that this 
collection (OMB 3220-0082), Application for Hospital Insurance 
Benefits, be renamed Medicare. Upon approval by OMB, the RRB intends to 
merge the following OMB approved Medicare-related collections into this 
collection by the expected expiration date(s).

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                                                                                                     Expected
        OMB Collection No.                          Title                        RRB forms          expiration
                                                                                                       date
----------------------------------------------------------------------------------------------------------------
3220-0189.........................  Evidence of Coverage Under an         RL-311-F..............       9/30/2001
                                     Employer Group Health Plan.
3220-0185.........................  Report of Medicaid State Office on    RL-380F...............       7/31/2002
                                     Beneficiary's Buy-In Status.
3220-0086.........................  Application for Reimbursement for     AA-104................       7/31/2002
                                     Hospital Insurance Services in
                                     Canada.
3220-0131.........................  Request for Medicare Payment........  G-740S................       8/31/2002
                                                                          HCFA-1500.............
3220-0100.........................  Request for Review of Part B          G-790.................     11/30/2002.
                                     Medicare Claim.                      G-791.................
----------------------------------------------------------------------------------------------------------------

    Revisions to existing collection instruments and, occasionally, a 
new instrument related to this program function may be required during 
the three-year cycle of this information collection.
    The RRB currently estimates the completion time for Form RL-311-F, 
Evidence of Coverage Under an Employer Group Health Plan at 10 minutes, 
Form RL-380F, Report of Problem to State Welfare Agency on Enrollees 
Medicare Status at 10 minutes, Form AA-104, Application for 
Reimbursement for Hospital Insurance Services in Canada at 10 minutes, 
Form G-740S, Patient's Request for Medicare Payment at 15 minutes, Form 
G-790, Request for Review of Part B Medicare Claim at 15 minutes, and 
Form G-791, Request for Hearing, Part B Medicare Claim at 15 minutes. 
After the last information collection is merged and other necessary 
adjustments are made,

[[Page 14325]]

the resultant information collection is expected to total approximately 
1,500 annual burden hours.
    A justification for each action described above (merge collection, 
revised collection instrument, new collection instrument) will be 
provided to OMB with a correction Change Worksheet (OMB Form 83-C) at 
the time the action occurs. With the next renewal of this collection, 
the RRB will update the information collection package to account for 
the consolidation and other interim adjustments.

ADDITIONAL INFORMATION OR COMMENTS: To request more information or to 
obtain a copy of the information collection justification, forms, and/
or supporting material, please call the RRB Clearance Officer at (312) 
751-3363. Comments regarding the information collection should be 
addressed to Ronald J. Hodapp, Railroad Retirement Board, 844 North 
Rush Street, Chicago, Illinois 60611-2092. Written comments should be 
received within 60 days of this notice.

Chuck Mierzwa,
Clearance Officer.
[FR Doc. 00-6538 Filed 3-15-00; 8:45 am]
BILLING CODE 7905-01-M