[Federal Register Volume 67, Number 193 (Friday, October 4, 2002)]
[Notices]
[Pages 62248-62249]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-25218]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifiers: CMS-377/378/R-54, CMS-359/360/R-55]


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.
    (1.) Type of Information Collection Request: Extension of a 
currently approved collection; Title of Information Collection: Request 
for Certification, CMS-377 and the Ambulatory Surgical Center Survey 
Report Form, CMS-378 and CMS-R-0054 Supporting Regulations Contained in 
42 CFR 416.1 thru 416.49; Form No.: CMS-0377/0378/R-0054 (OMB 
0938-0200); Use: The ASC request for certification form is utilized as 
an application for facilities wishing to participate in the Medicare 
program as an ASC. This form initiates the process of obtaining a 
decision as to whether the conditions of coverage are met. It also 
promotes data retrieval from the Online Data Input Edit (ODIE system, a 
subsystem of the Online Survey Certification and Report (OSCAR) system 
by CMS Regional Offices (RO)). The ASC report form is an instrument 
used by the State survey agency to record data collection in order to 
determine supplier compliance with individual conditions of coverage 
and to report it to the Federal government. The form is primarily a 
coding worksheet designed to facilitate data reduction and retrieval 
into the ODIE/OSCAR system at the CMS ROs. This form includes basic 
information on compliance (i.e., met, not met and explanatory 
statements) and does not require any descriptive information regarding 
the survey activity itself; Frequency: Annually; Affected Public: 
State, Local, or Tribal Government; Number of Respondents: 2,798; Total 
Annual Responses: 2,798; Total Annual Hours: 2,100.
    (2.) Type of Information Collection Request: Extension of a 
currently approved collection; Title of Information Collection: 
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and 
Survey Forms and Information Collection Requirements in 42 CFR 485.56, 
485.58, 485.60, 485.64, 485.66, 410.105; Form No.: CMS-0359/0360/R-0055 
(OMB 0938-0267); Use: In order to participate in the Medicare 
program as a CORF, providers must meet federal conditions of 
participation. The certification form is needed to determine if 
providers meet at least preliminary requirements. The survey form is 
used to record provider compliance with the individual conditions and 
report findings to CMS; Frequency: Annually; Affected Public: State, 
Local, or Tribal Government; Number of Respondents: 556; Total Annual 
Responses: 556; Total Annual Hours: 264,877.
    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 Strategic 
Operations and Regulatory Affairs, Division of Regulations Development 
and Issuances, Attention: Dawn Willinghan, Room N2-14-26, 7500 Security

[[Page 62249]]

Boulevard, Baltimore, Maryland 21244-1850.

    Dated: September 26, 2002.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Strategic Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 02-25218 Filed 10-3-02; 8:45 am]
BILLING CODE 4120-03-P