[Federal Register Volume 65, Number 92 (Thursday, May 11, 2000)]
[Notices]
[Pages 30414-30415]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-11846]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-1500]


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.
    Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Health Insurance 
Common Claims Form and Supporting Regulations in 42 CAR 414.40, 424.32, 
and 424.44; Form No.: HCFA-1500, 1490U, and 1490S (OMB# 0938-0008); 
Use: This form is a standardized form for use in the Medicare/Medicaid 
programs to apply for reimbursement for covered services; Frequency: On 
occasion; Affected Public: Business or other for-profit, Not-for-profit 
institutions; Number of Respondents: 1,321,417; Total Annual Responses: 
717,876,097; Total Annual Hours: 44,460,460.
    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 [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

[[Page 30415]]

the OMB desk officer: OMB Human Resources and Housing Branch, 
Attention: Allison Eydt, New Executive Office Building, Room 10235, 
Washington, D.C. 2050.

    Dated: April 17, 2000.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 00-11846 Filed 5-10-00; 8:45 am]
BILLING CODE 4120-03-P