[Federal Register Volume 66, Number 69 (Tuesday, April 10, 2001)]
[Notices]
[Pages 18646-18647]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-8730]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-1500]


Agency Information Collection Activities: Submission for OMB 
Review; 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;

[[Page 18647]]

(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: HCFA-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 maintained; 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 
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: OMB 
Human Resources and Housing Branch, Attention: Wendy Taylor, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: March 19, 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. 01-8730 Filed 4-9-01; 8:45 am]
BILLING CODE 4120-03-U