[Federal Register Volume 67, Number 177 (Thursday, September 12, 2002)]
[Notices]
[Pages 57826-57827]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-23246]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-484]


Agency Information Collection Activities: Submission for OMB 
Review; 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: Attending Physician's 
Certification of Medical Necessity for Home Oxygen Therapy and 
Supporting Regulations 42 CFR 410.38 and 42 CFR 424.5.
    Form No.: 0938-0534 (CMS-484).
    Use: This form is used to determine if oxygen is reasonable and 
necessary pursuant to Medicare Statute; Medicare claims for home oxygen 
therapy must be supported by the treating physician's statement and 
other information

[[Page 57827]]

including estimate length of need ( of months), diagnosis 
codes (ICD-9) etc.
    Frequency: As needed.
    Affected Public: Business of other for-profit.
    Number of Respondents: 175,000.
    Total Annual Responses: 500,000.
    Total Annual Hours: 50,000.
    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 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 30 days of this notice directly to the OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Brenda Aguilar, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: September 4, 2002.
John P. Burke III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Regulatory Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 02-23246 Filed 9-11-02; 8:45 am]
BILLING CODE 4120-03-P