[Federal Register Volume 65, Number 150 (Thursday, August 3, 2000)]
[Notices]
[Page 47739]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-19678]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-199 & HCFA-255]


Agency Information Collection Activities: Proposed Collection; 
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: Medicaid Report on Payables and 
Receivables;
    Form No.: HCFA-R-199 (OMB# 0938-0697);
    Use: The Chief Financial Officers Act of 1990 requires government 
agencies to produce auditable financial statements. This form will 
collect accounting data from the States on Payables and Receivables;
    Frequency: Annually;
    Affected Public: State, Local or Tribal Government;
    Number of Respondents: 57;
    Total Annual Responses: 57;
    Total Annual Hours: 342.
    (2) Type of Information Collection Request: Extension of a 
currently approved collection;
    Title of Information Collection: Municipal Health Services Cost 
Report Form and Supporting Regulations in 42 CFR 405.2470;
    Form No.: HCFA-255 (OMB# 0938-0155);
    Use: The Municipal Health Services Program Cost Report (HCFA-255) 
is used by the participating clinics to report costs for health care 
services rendered to Medicare beneficiaries. It is also used to gather 
data to properly evaluate the demonstration. It has been in use since 
1979;
    Frequency: Annually;
    Affected Public: State, Local or Tribal Government, and Not-for-
profit institutions;
    Number of Respondents: 14;
    Total Annual Responses: 14;
    Total Annual Hours: 476.
    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 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: Dawn Willinghan, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: July 25, 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. 00-19678 Filed 8-2-00; 8:45 am]
BILLING CODE 4120-03-P