[Federal Register Volume 66, Number 52 (Friday, March 16, 2001)]
[Notices]
[Page 15264]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-6512]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-10028]


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.
    Type of Information Collection Request: New collection; Title of 
Information Collection: State Health Insurance Assistance Program 
(SHIP) Client Contact Form; Form No.: HCFA-10028 (OMB# 0938-NEW); Use: 
The State Health Insurance Assistance Program (SHIP) Client Contact 
Form will be completed by SHIP counselors at each counseling event to 
collect SHIP performance data, which will then be accumulated and 
analyzed to measure performance; Frequency: Semi-annually, Annually; 
Affected Public: State, local, or tribal gov.; Number of Respondents: 
53; Total Annual Responses: 265; Total Annual Hours: 159. 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: Julie Brown, HCFA 10028, Room N2-14-
26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 7, 2001.
John P. Burke III,
Reports Clearance Officer, Security and Standards Group, Division of 
HCFA Enterprise Standards.
[FR Doc. 01-6512 Filed 3-15-01; 8:45 am]
BILLING CODE 4120-03-P