[Federal Register Volume 67, Number 33 (Tuesday, February 19, 2002)]
[Notices]
[Page 7379]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-3988]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Center for Medicare and Medicaid Services

[Docket Identifier: CMS-10048]


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request

AGENCY: Center for Medicare and Medicaid Services, HHS.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Center 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: 10, Total 
Annual Responses: 10; Total Annual Hours: 50.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and CMB 
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: Allison Eydt, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: January 24, 2002.
John P. Burke, III,
CMS Reports Clearance Officer, CMS Office of Information Services, 
Security and Standards Group, Division of CMS Enterprise Standards.
[FR Doc. 02-3988 Filed 2-15-02; 8:45 am]
BILLING CODE 4120-03-M