[Federal Register Volume 69, Number 79 (Friday, April 23, 2004)]
[Notices]
[Page 22060]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-9271]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-265]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & 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: Independent Renal Dialysis 
Facility Cost Report Form and Supporting Regulations in 42 CFR 413.20, 
413.24.
    Form No.: CMS-265 (OMB 0938-0236).
    Use: The Medicare Independent Renal Dialysis Facility Cost Report 
provides for determinations and allocation of costs to the components 
of the Renal Dialysis facility in order to establish a proper basis for 
Medicare payment.
    Frequency: Annually.
    Affected Public: Business or other for-profit, not-for-profit 
institutions, and State, Local, or Tribal Government.
    Number of Respondents: 3,592.
    Total Annual Responses: 3,592.
    Total Annual Hours: 704,032.
    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: April 15, 2004.
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. 04-9271 Filed 4-22-04; 8:45 am]
BILLING CODE 4120-03-P