[Federal Register Volume 61, Number 65 (Wednesday, April 3, 1996)]
[Notices]
[Pages 14799-14800]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-8054]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Health Care Financing Administration, HHS.
In compliance with the Paperwork Reduction Act of 1995 (44 U.S.C.
3501 et seq.), the Health Care Financing Administration (HCFA),
Department of Health and Human Services, has submitted to the Office of
Management and Budget (OMB) the following proposals for the collection
of information. Interested persons are invited to send comments
regarding the burden estimate or any other aspect of this collection of
information, including any of the following subject: (1) The necessity
and utility of 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: New collection; Title of
Information Collection: Maximizing the Effectiveness of Home Health
Care: The Influence of Service Volume and Integration With Other Care
Settings on Patient Outcomes; Form No.: HCFA-R-189; Use: This study
will examine (1) the relationship of home health care service volume
and patient outcomes, and (2) the relationship of the physician role
and integration of other services and patient outcomes; Frequency:
Other (periodically); Affected Public: Not-for-profit institutions,
business or other for profit, and individuals or households; Number of
Respondents: 6,300; Total Annual Hours: 3,573.
2. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Request for Certification in
the Medicare and/or Medicaid Program to Provide Outpatient Physical
Therapy and/or Speech Pathology Services, Outpatient Physical Therapy
Speech Pathology Survey Report; Form Nos.: HCFA-1856, HCFA-1893; Use:
The Medicare Program requires outpatient physical therapy providers to
meet certain health and safety requirements. The request for
certification form is used by State agency surveyors to determine if
minimum Medicare eligibility requirements are met. The survey report
form records the result of the onsite survey; Frequency: On occasion;
Affected Public: Business or other for profit; Number of Respondents:
1,700; Total Annual Hours: 446.25.
3. Type of Information Collection Request: Reinstatement, with
change, of a previously approved collection for which approval has
expired; Title of Information Collection: Request for Certification as
Supplier of Portable X-ray Services Under the Medicare/
[[Page 14800]]
Medicaid Programs, Portable X-ray Survey Report; Form Nos.: HCFA-1880,
HCFA-1882; Use: The Medicare program requires portable x-ray suppliers
to be surveyed for health and safety standards. The HCFA-1882 is the
survey form that records survey results. The HCFA-1880 is used by the
surveyors to determine if a portable x-ray applicant meets the
eligibility requirements; Frequency: On occasion; Affected Public:
Business or other for profit; Number of Respondents: 520; Total Annual
Hours: 137.
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Physical
Therapist in Independent Practice Request for Certification in the
Medicare Program; Form No.: HCFA-262; Use: The HCFA-262 is used by the
surveyors to determine if a physical therapist in independent practice
requesting Medicare approval meets the eligibility requirements;
Frequency: On occasion; Affected Public: Business or other for profit;
Number of Respondents: 7,322; Total Annual Hours: 1,098.
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Request for
Approval as a Hospital Provider of Extended Care Services (Swing-Bed)
in the Medicare and Medicaid Programs; Form No.: HCFA-605; Use: The
HCFA-605 is used for facility identification and screening. It will be
completed by a hospital that is requesting approval and will initiate
the process of determining the hospital's eligibility and for which bed
count category the hospital wishes to request approval; Frequency:
Other (one-time usage for initial application); Affected Public:
Business or other for profit, not-for-profit institutions, Federal
Government; Number of Respondents: 1,500; Total Annual Hours: 375.
6. Galley Revision of a currently approved collection; Title of
Information Collection: Organ Procurement Organization's Request for
Designation; Form No.: HCFA-576; Use: The information provided on this
form serves as a basis for certifying organ procurement organizations
(OPO) for participation in the Medicare and Medicaid programs and will
indicate whether the OPO is meeting the specified performance standards
for reimbursement of service; Frequency: Biennially; Affected Public:
Business or other for profit, not-for-profit institutions; Number of
Respondents: 80; Total Annual Hours: 160.
To request copies of the proposed paperwork collections referenced
above, E-mail your request, including your address, to
P[email protected], or call the Reports Clearance Office on (410) 786-
1326. Written comments and recommendations for the proposed information
collections should be sent within 30 days of this notice directly to
the OMB Desk Officer designated at the following address: OMB Human
Resources and Housing Branch, Attention: Allison Eydt, New Executive
Office Building, Room 10235, Washington, D.C. 20503.
Dated: March 27, 1996.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-8054 Filed 4-2-96; 8:45 am]
BILLING CODE 4120-03-P-M