[Federal Register Volume 68, Number 197 (Friday, October 10, 2003)]
[Notices]
[Pages 58689-58690]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-25765]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-2649, CMS-730 and CMS-80]


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

[[Page 58690]]

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 Reconsideration of 
Part A Medicare Claims and Supporting Regulations in 42 CFR, 405.711.
    Form No.: CMS-2649 (OMB 0938-0045).
    Use: Section 1869 of the Social Security Act authorizes a hearing 
for any individual who is dissatisfied with the intermediary's 
determination or amount of benefit paid. This form is used so that a 
party may request a reconsideration of the initial determination.
    Frequency: Monthly, Quarterly, Annually.
    Affected Public: Individuals or Households and Not-for-profit 
institutions.
    Number of Respondents: 60,000.
    Total Annual Responses: 60,000.
    Total Annual Hours: 15,000.
    2. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Employee Building Pass Application 
and File.
    Form No.: CMS-730 & CMS-80 (OMB 0938-0812).
    Use: The purpose of this system is to control United States 
Government Building Passes issued to all Centers for Medicare & 
Medicaid Services (CMS) employees and non-CMS employees who require 
continuous access to CMS buildings in Baltimore and other CMS and HHS 
Buildings.
    Frequency: As needed.
    Affected Public: Federal Government and Business or other for-
profit.
    Number of Respondents: 2000.
    Total Annual Responses: 2000.
    Total Annual Hours: 500.
    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.

    Dated: October 2, 2003.
Dawn Willinghan,
CMS Reports Clearance Officer, Office of Strategic Operations and 
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 03-25765 Filed 10-9-03; 8:45 am]
BILLING CODE 4120-03-P