[Federal Register Volume 67, Number 119 (Thursday, June 20, 2002)]
[Notices]
[Pages 42025-42026]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-15532]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-194]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers 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 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: Medicare 
Disproportionate Share Adjustment Procedure and Criteria and Supporting 
Regulations in 42 CFR 412.106; Form No.: CMS-R-194 (OMB 0938-
0691); Use: Regulation sets up an alternative process for hospitals 
that choose to have their disproportionate share adjustment statistics 
calculated based on their cost reporting periods rather than the 
Federal fiscal year. Frequency: On occasion; Affected Public: Business 
or other for-profit, and not-for-profit institutions; Number of 
Respondents: 100; Total Annual Responses: 100; Total Annual Hours 
Requested: 100.
    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.

[[Page 42026]]

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: Dawn 
Willinghan, CMS-R-194, Room N2-14-26, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.

    Dated: June 12, 2002.
John P. Burke III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, CMS 
Office of Information Services, Security and Standards Group, Division 
of CMS Enterprise Standards.
[FR Doc. 02-15532 Filed 6-19-02; 8:45 am]
BILLING CODE 4120-03-P