[Federal Register Volume 68, Number 95 (Friday, May 16, 2003)]
[Notices]
[Page 26620]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-12228]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-38, CMS-R-30, CMS-1957, CMS-R-48, CMS-43, 
and CMS-R-143]


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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Conditions for 
Coverage for Rural Health Clinics--42 CFR 491.9 Subpart A; Form No.: 
CMS-R-38 (OMB 0938-0334); Use: This information is needed to 
determine if rural health clinics meet the requirements for approval 
for Medicare Participation.; Frequency: Initial Application for 
Medicare approval; Affected Public: Business or other for-profit, 
State, Local, or Tribal Gov't., and not-for-profit institutions, 
Individuals or households, Farms, and Federal Government; Number of 
Respondents: 3,305; Total Annual Responses: 3,305; Total Annual Hours: 
8,580.
    2. Type of Information Collection Request: Reinstatement, with 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Information Collection 
Requirements in the Hospice Conditions for Coverage and supporting 
regulations in 42 CFR 418.22; 418.24; 418.28; 418.56(b),(e)(1), (e)(3); 
418.58; 418.70(e); 418.83; 418.86(b); and 418.100(b).; Form No.: CMS-R-
30 (OMB 0938-0302); Use: Establishes standards for hospices 
that wish to participate in the Medicare program. The regulations 
establish standards for eligibility, reimbursement standards, and 
procedure, and delineate conditions that hospices must meet to be 
approved for participation in Medicare.; Frequency: Record Keeping; On 
occasion; Affected Public: Business or other for-profit; Number of 
Respondents: 2,311; Total Annual Responses: 2,311; Total Annual Hours: 
10,821,923.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: SSO Report of 
State Buy-In Problems and Supporting Regulation at 42 CFR 407.40; Form 
No.: HCFA-1957; Use: The HCFA-1957 is issued to assist with 
communications between the Social Security District Offices, Medicaid 
State Agencies and HCFA Central Offices in the resolution of 
beneficiary entitlement under state buy-ins. It is used when a problem 
arises which cannot be resolved thru normal data exchange. Frequency: 
On occasion; Affected Public: Individuals or Households, State, Local 
or Tribal Government; Number of Respondents: 3,000; Total Annual Hours: 
1075.
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Hospital COP-42 
CFR 482.12, 482.13, 482.22, 482.27, 482.30, 482.41, 482.43, 482.53, 
482.56, 482.57, 482.60, 482.61, 482.62, 482.66, 485.618, and 485.631; 
Form No.: CMS-R-48 (OMB  0938-0328); Use: Hospitals seeking to 
participate in the Medicare and Medicaid programs must meet the 
Conditions of Participation (COP) for Hospitals, 42 CFR Part 482. The 
information collection requirements contained in this package are 
needed to implement the Medicare and Medicaid COP for hospitals.; 
Frequency: Annually; Affected Public: Business or other for-profit, 
Not-for-profit institutions, Federal Government, State, Local, or 
Tribal Gov.; Number of Respondents: 6,017; Total Annual Responses: 
6,017; Total Annual Hours: 4,798,575.40.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Application for 
Health Insurance Benefits Under Medicare for Individuals with Chronic 
Renal Disease and Supporting Regulations in 42 CFR 406.7 and .13; Form 
No.: 0938-0080; Use: The CMS-43 is used to establish entitlement to 
Medicare by individuals with End Stage Renal Disease; Frequency: One-
time only; Affected Public: Individuals or Households, Federal 
Government, State, Loval, or Tribal Gov.; Number of Respondents: 
60,000; Total Annual Responses: 60,000; Total Annual Hours: 26,000.
    6. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Analysis of 
Malpractice Premium Data; Form No.: CMS-R-143 (OMB 0938-0575); 
Use: Survey of medical liability insurers for use in computing the 
malpractice component of the geographic practice cost index and the 
malpractice relation value units.; Frequency: Every 3 years.; Affected 
Public: State, Local, or Tribal Gov't., Business or other for-profit, 
and not-for-profit insitutions; Number of Respondents: 50; Total Annual 
Responses: 50; Total Annual Hours: 150.
    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://cms.hhs.gov/regulations/pra/default.asp, 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, Fax 
Number: (202) 395-6974.

    Dated: May 8, 2003.
Dawn Willinghan,
CMS Reports Clearance Officer, Division of Regulations Development and 
Issuances, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 03-12228 Filed 5-15-03; 8:45 am]
BILLING CODE 4120-03-P