[Federal Register Volume 70, Number 121 (Friday, June 24, 2005)]
[Notices]
[Pages 36612-36613]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-12161]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-339]


Agency Information Collection Activities: Proposed Collection; 
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 & Medicaid 
Services (CMS) 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

[[Page 36613]]

other forms of information technology to minimize the information 
collection burden.
    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare Provider 
Cost Report Reimbursement Questionnaire and Supporting Regulations in 
42 CFR 413.20, 413.24, and 415.60; Form Nos.: CMS-339 (OMB  
0938-0301); Use: The purpose of Form CMS-339 is to assist the provider 
in preparing an acceptable cost report and to minimize subsequent 
contact between the provider and its intermediary. Form CMS-339 
provides the basic data necessary to support the information in the 
cost report. This includes information the provider uses to develop the 
provider and professional components of physician compensation so that 
compensation can be properly allocated between the Part A and the Part 
B trust funds. CMS is currently working on eliminating Form CMS-339 and 
including the applicable questions on the individual cost report forms. 
Because of the time required to include the applicable questions in 
each of the individual cost reports, CMS is revising the currently 
approved information collection; Frequency: Annually; Affected Public: 
Business or other for-profit, not-for-profit institutions, State, local 
or tribal governments; Number of Respondents: 35,904; Total Annual 
Responses: 35,904; Total Annual Hours: 618,210.
    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://www.cms.hhs.gov/regulations/pra/, 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 to the address 
below: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: William N. Parham, III, 
PRA Analyst, Room C5-13-27, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: June 3, 2005.
Jim L. Wickliffe,
CMS Reports Clearance Officer, Regulations Development Group, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 05-12161 Filed 6-23-05; 8:45 am]
BILLING CODE 4120-01-P