[Federal Register Volume 60, Number 148 (Wednesday, August 2, 1995)] [Notices] [Pages 39403-39404] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 95-18942] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Care Financing Administration Public Information Collection Requirements Submitted for Public Comment and Recommendations In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Health Care Financing Administration (HCFA), Department of Health and Human Services (HHS), is publishing the following summaries of proposed collections for public comment. 1. Type of Information Collection Request: Reinstatement, with change, of a previously approved collection for which approval has expired; Title of Information Collection: Peer Review Organization (PRO) Reporting Forms; Form Nos.: HCFA 613-627; Use: PROs are authorized to review inpatient and outpatient services for quality of care provided and to eliminate unreasonable, unnecessary, and inappropriate care provided to Medicare beneficiaries. The PROs are required to report the results of the review to HCFA. Frequency: Monthly, quarterly; Affected Public: Business or other for profit; Number of Respondents: 53; Total Annual Hours: 10,759. 2. Type of Information Collection Request: New Collection; Title of Information Collection: Evaluation of the Oregon Medicaid Reform Demonstration, Baseline Survey; Form No.: HCFA R-179; Use: The baseline survey is one component in the evaluation of the Oregon Medicaid Reform Demonstration (OMRD), a demonstration authorized under section 115 of the Social Security Act. The purpose of the survey is to gather information on the health status, past utilization, and level of satisfaction of a sample of newly enrolled OMRD recipients, in a way that allows followup contact, and maximizes the likelihood of preenrollment recall. Frequency: Annually; Affected Public: Individuals or households; Number of Respondents: 2,667; Total Annual Hours: 500. 3. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Information Collection Requirements in HSQ 108-F, Assumption of Responsibilities; Form No.: HCFA R-71; Use: Rule establishes the review functions to be performed by the PRO and outlines the relationships among PROs, providers, practitioners, beneficiaries, fiscal intermediaries, and carriers. Frequency: Monthly, quarterly; Affected Public: Business or other for profit; Number of Respondents: 53; Total Annual Hours: 46,653. 4. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medical Records Review Under Prospective Payment System (PPS); Form No.: HCFA R-50; Use: PROs are authorized to conduct medical review activities under the PPS. In order to conduct medical review activities, we depend upon hospitals to make available specific records. Frequency: Annually; Affected Public: Business or other for profit; Number of Respondents: 6,412; Total Annual Hours: 22,400. 5. Type of Information Collection Request: New Collection; Title of Information Collection: Evaluation of the Medicare Cataract Surgery Alternate Payment Demonstration; Form No.: HCFA-R-177; Use: To test the feasibility of a negotiated bundled payment for the entire episode of cataract surgery with an intraocular lens implant and, provide insight into appropriateness indicators and effective quality assurance and utilization review mechanisms for cataract surgery. Frequency: Annually; Affected Public: Business or other for profit institutions; Number of Respondents: 1,686; Total Annual Hours: 506. 6. Type of Information Collection Request: Reinstatement, without change, of a previously approved collection for which approval has expired; Title of Information Collection: Home Health Agency Survey and Deficiencies Report, Home Health Functional Assessment Instrument; Form Nos.: HCFA-1572, HCFA-1515; Use: In order to participate in the Medicare program as a home health agency (HHA) provider, the HHA must meet Federal standards. These forms are used to record information about patients' health and provider compliance with requirement and report information to the Federal Government. Frequency: Annually; Affected Public: Business or other for profit; Number of Respondents: 8,622; Total Annual Hours: 129,330. 7. Type of Information Collection Request: Reinstatement, without change, of a previously approved collection for which approval has expired; Title of Information Collection: Survey Team Composition and Workload Report; Form No.: HCFA-670; Use: This form will provide information on resource utilization applicable to survey activity in the Medicare/Medicaid provider/supplier types and Clinical Laboratory Improvement Amendment (CLIA) laboratories. This information will assist HCFA in determining Federal reimbursement for surveys conducted. Frequency: Annually; Affected Public: State, local, or tribal governments; Number of Respondents: 53; Total Annual Hours: 71,667. 8. Type of Information Collection Request: New collection; Title of Information Collection: Field Testing of the Uniform Needs Assessment Instrument; Form No.: HCFA-R-180; Use: The validity, reliability, and administrative feasibility of the Uniform Needs Assessment instrument will be [[Page 39404]] tested in a small-scale trial. Also, a high risk screener will be developed to identify hospital patients in need of extensive discharge planning. Testing will be done in two phases approximately 1 year apart. Each phase will involve 12 provider sites, 420 patients, and 840 total assessments. Frequency: Annually; Affected Public: Individuals or households, business or other for profit, and not-for-profit institutions; Number of Respondents: 420; Total Annual Hours: 1,050. To request copies of the proposed paperwork collections referenced above, call the Reports Clearance Office on (410) 786-1326. Written comments and recommendations for the proposed information collections should be sent within 60 days of this notice directly to the HCFA Paperwork Clearance Officer designated at the following address: HCFA, Office of Financial and Human Resources, Management Planning and Analysis Staff, Attention: John Burke, Room C2-26-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850. Dated: July 24, 1995. Kathleen B. Larson, Director, Management Planning and Analysis Staff, Office of Financial and Human Resources, Health Care Financing Administration. [FR Doc. 95-18942 Filed 8-1-95; 8:45 am] BILLING CODE 4120-03-P