[Federal Register Volume 62, Number 195 (Wednesday, October 8, 1997)]
[Notices]
[Pages 52566-52567]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-26564]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-437]


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

    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, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal 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 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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Psychiatric Unit 
Criteria Work Sheet, Rehabilitation Unit Criteria Work Sheet, 
Rehabilitation Hospital Criteria Work sheet and Supporting Regulations 
42 CFR 412.20-412.32; Form No.: HCFA-437, OMB # 0938-0358; Use: 
Rehabilitation hospitals and Psychiatric hospital units that are 
excluded from the Medicare Prospective Payment System (PPS) must 
complete the criteria work sheets to verify and reverify that they 
comply and remain in compliance with the exclusion criteria for the 
Medicare prospective payment system. These forms capture information 
that will allow Medicare to reimburse these facilities on the basis of 
a nationally-determined average standardized amounts, i.e., a 
prospective payment type system. Frequency: Annually; Affected Public: 
Business or other for-profit, Not-for-profit institutions and State, 
Local or Tribal Government; Number of Respondents: 2,555; Total Annual 
Responses: 2,555; Total Annual Hours: 639.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Information 
Collection Requirements Referenced in 42 CFR 411.404(c)(2)+(3), 
411.406(c)+(d): Procedures for Determining Whether Providers, 
Practitioners, or other suppliers of services are liable for certain 
noncovered services; Form No.: HCFA-R-77, OMB # 0938-0465; Use: BERC-
273-F requires Peer Review Organizations (PROs) to provide written 
notification of noncovered services to beneficiaries and/or providers, 
practitioners and suppliers. The notification provides provider, 
practitioner or supplier with knowledge that Medicare will not pay for 
items or services mentioned in the notification. After this 
notification, any future claim for the same or similar services will 
not be paid. Frequency: Monthly; Affected Public: Business or other 
for-profit, Individuals or Households; Number of Respondents: 724,271; 
Total Annual Responses: 2,897,085; Total Annual Hours: 241,424.

[[Page 52567]]

    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, or to obtain the supporting 
statement and any related forms, E-mail your request, including your 
address and phone number, to P[email protected], or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
by November 7, 1997 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: September 30, 1997.
John P. Burke III,
HCFA Reports Clearance Officer HCFA, Office of Information Services, 
Information Technology Investment Management Group, Division of HCFA 
Enterprise Standards.
[FR Doc. 97-26564 Filed 10-7-97; 8:45 am]
BILLING CODE 4120-03-P