[Federal Register Volume 66, Number 56 (Thursday, March 22, 2001)]
[Notices]
[Page 16062]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-7134]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-10003]


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.
    Type of Information Collection Request: New Collection;
    Title of Information Collection: Medicare + Choice Beneficiary 
Appeal Notices, ``Notice of Denial of Medical Services'', ``Notice of 
Denial of Request for Payment'' and Supporting Regulations in 42 CFR 
422.568;
    Form No.: HCFA-10003 (OMB# 0938-NEW);
    Use: This collection includes two Medicare + Choice appeal notices, 
Denial of Service and Denial of Payment. Pursuant to the Social 
Security Act Section 1852(g)(1)(B), M+C organizations are required to 
issue notices to Medicare managed care beneficiaries when a request for 
either medical service or payment is denied. Additionally, the notices 
inform beneficiaries of their right to file an appeal.
    All M+C organizations will be required to use these forms. Neither 
the Health Care Financing Administration (HCFA) nor the M+C 
organizations will use such notices to collect and analyze data on M+C 
beneficiary appeals. They are for information purposes only. These 
forms have been revised in accordance with public comments received 
during the 60-day comment period.;
    Frequency: On occasion;
    Affected Public: Business or other for-profit and Individuals or 
Households;
    Number of Respondents: 29,892;
    Total Annual Responses: 29,892;
    Total Annual Hours: 2,994.
    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: March 1, 2001.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 01-7134 Filed 3-21-01; 8:45 am]
BILLING CODE 4120-03-P