[Federal Register Volume 66, Number 206 (Wednesday, October 24, 2001)]
[Notices]
[Page 53801]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-26783]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10048]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid 
Services (CMS) (formerly known as 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: Extension of 
a currently approved collection; Title of Information Collection: 
Health Insurance Flexibility and Accountability Section 1115 Model 
Waiver; Form No.: CMS-10048 (OMB# 0938-0848); Use: This Health 
Insurance Flexibility and Accountability (HIFA) Section 1115 Model 
Demonstration will enable states to use Medicaid and SCHIP funds in 
concert with private health insurance options to expand coverage to 
low-income uninsured individuals, with a focus on those with income at 
or below 200 percent of the Federal poverty level. The model 
demonstration application will facilitate State efforts in designing 
programs to cover the uninsured; Frequency: Other: 5 years after 
initial submission; Affected Public: State, Local or Tribal Government; 
Number of Respondents: 25; Total Annual Responses: 25; Total Annual 
Hours: 250.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS'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 CMS Paperwork Clearance 
Officer designated at the following address: CMS, Office of Information 
Services, Security and Standards Group, Division of CMS Enterprise 
Standards, Attention: Julie Brown, CMS-10048, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: October 17, 2001.
John P. Burke III,
Reports Clearance Officer, Security and Standards Group, Division of 
CMS Enterprise Standards.
[FR Doc. 01-26783 Filed 10-23-01; 8:45 am]
BILLING CODE 4120-03-P