[Federal Register Volume 66, Number 85 (Wednesday, May 2, 2001)]
[Notices]
[Pages 21987-21988]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-10882]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-231]


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,

[[Page 21988]]

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+Choice (M+C) 
Provider Sponsored Organization (PSO) Waiver Request Form and 
Supporting Regulations in 42 CFR 422.370-422.378; Form Number: HCFA-R-
231 (0938-0722); Use: The PSO waiver request form is for use by PSO's 
that do not have a State risk-bearing entity licence and that wish to 
enter into a M+C contract with HCFA to provide prepaid health care 
services to eligible Medicare beneficiaries. HCFA will use the 
information requested on this form to determine whether the applicant 
is eligible for a waiver of the state licensure requirement for M+C 
organizations as allowed under section 1855(a)(2) of the Social 
Security Act.; Frequency: One-time.; Affected Public: Business or other 
for-profit, Not-for-profit institutions, and Federal Government.; 
Annual Number of Respondents: 10.; Total Annual Responses: 10.; Total 
Annual Hours Requested: 100.
    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: Dawn Willinghan, HCFA-R-231, Room N2-
14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: April 23, 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. 01-10882 Filed 5-1-01; 8:45 am]
BILLING CODE 4120-03-P