[Federal Register Volume 70, Number 52 (Friday, March 18, 2005)]
[Notices]
[Pages 13216-13217]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-5419]


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RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

SUMMARY: In accordance with the requirement of Section 3506(c)(2)(A) of

[[Page 13217]]

the Paperwork Reduction Act of 1995 which provides opportunity for 
public comment on new or revised data collections, the Railroad 
Retirement Board (RRB) will publish periodic summaries of proposed data 
collections.
    Comments are invited on: (a) Whether the proposed information 
collection is necessary for the proper performance of the functions of 
the agency, including whether the information has practical utility; 
(b) the accuracy of the RRB's estimate of the burden of the collection 
of the information; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden related to the collection of information on respondents, 
including the use of automated collection techniques or other forms of 
information technology.

Title and Purpose of Information Collection

    Application for Reimbursement for Hospital Insurance Services in 
Canada; OMB 3220-0086. Under section 7(d) of the Railroad Retirement 
Act (RRA), the RRB administers the Medicare program for persons covered 
by the railroad retirement system. Payments are provided under section 
7(d)4) of the RRA for medical services furnished in Canada to the same 
extent as for those furnished in the United States. However, payments 
for the services furnished in Canada are made from the Railroad 
Retirement Account rather than from the Federal Hospital Insurance 
Trust Fund, with the payments limited to the amount by which insurance 
benefits under Medicare exceed the amounts payable under Canadian 
Provincial plans.
    Form AA-104, Application for Canadian Hospital Benefits Under 
Medicare--Part A, is provided by the RRB for use in claiming benefits 
for covered hospital services received in Canada. The form obtains 
information needed to determine eligibility for, and the amount of any 
reimbursement due the applicant. One response is requested of each 
respondent. Completion is required to obtain a benefit.
    No changes are proposed to Form AA-104.
    Number of respondents: 50.
    Estimated completion time: 10 minutes.
    Estimated annual burden hours: 8.
    Additional Information or Comments: To request more information or 
to obtain a copy of the information collection justification, forms, 
and/or supporting material, please call the RRB Clearance Officer at 
(312) 751-3363 or send an e-mail request to [email protected]. 
Comments regarding the information collection should be addressed to 
Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois 60611-2092 or send an e-mail to 
[email protected]. Written comments should be received within 60 
days of this notice.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 05-5419 Filed 3-17-05; 8:45 am]
BILLING CODE 7905-01-P