[Federal Register Volume 67, Number 5 (Tuesday, January 8, 2002)]
[Notices]
[Page 901]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-422]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-10001]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare and Medicaid Services.
    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: HIPAA 
Nondiscrimination Provisions; Form No.: CMS-10001 (OMB# 0938-0827); 
Use: Self-funded nongovernmental plans are required to give individuals 
who were previously discriminated against an opportunity to enroll, 
including notice of an opportunity to enroll; Frequency: Once; Affected 
Public: Business or other for-profit, not-for-profit institutions, 
Individuals or households, State, local, or tribal government; Number 
of Respondents: 583; Total Annual Responses: 583; Total Annual Hours: 
200.
    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 CMS 
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 10001, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: December 20, 2001.
Julie E. Brown,
Acting Reports Clearance Officer, Security and Standards Group, 
Division of CMS Enterprise Standards.
[FR Doc. 02-422 Filed 1-7-02; 8:45 am]
BILLING CODE 4120-03-P