[Federal Register Volume 65, Number 204 (Friday, October 20, 2000)]
[Notices]
[Page 63081]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-27025]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

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


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    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, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal for the collection of information. Interested persons are 
invited to send comments regarding the 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 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 and phone number, 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 the OMB Desk Officer 
designated at the following address: OMB Human Resources and Housing 
Branch, Attention: Allison Eydt, New Executive Office Building, Room 
10235, Washington, DC 20503.

    Dated: October 11, 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. 00-27025 Filed 10-19-00; 8:45 am]
BILLING CODE 4120-03-P