[Federal Register Volume 66, Number 9 (Friday, January 12, 2001)]
[Notices]
[Pages 2912-2913]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-1070]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Docket Identifier: HCFA-1500]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration, DHHS.
    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 Request: Extension of a currently approved 
collection; Title of Information Collection; Medicare/Medicaid Health 
Insurance Common Claim Form, Instructions, and Supporting Regulations: 
42 CFR 414.40, 424.32, 424.44; Form Number: NCFA-1500, HCFA-1490U, 
HCFA-1490S (OMB approval #: 0938-0008); Use: This form is a 
standardized form for use in the Medicare/Medicaid programs to apply 
for reimbursement for covered services. In addition, it reduces cost 
and administrative burdens associated with claims since only one coding 
system is used and maintanined; Frequency: On occasion; Affected 
Public: Business or other for-profit, Not-for-profit institutions; 
Number of Respondents: 1,321,417; Total Annual Responses: 1,321,417; 
Total Annual Hours Requested: 44,189,007.
    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

[[Page 2913]]

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: Julie Brown, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 01-1070 Filed 1-11-01; 8:45 am]
BILLING CODE 4120-03-M