Agency Information Collection Activities: Proposed Collection; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

Agency Information Collection Activities: Proposed Collection;

Comment Request

AGENCY: Health Care Financing Administration, HHS.

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, is

publishing the following summaries of proposed collection for public

comment. 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: Payment

Adjustment for Sole Community Hospitals; Form No.: HCFA-R-79; Use:

Hospitals designated as ``Sole Community Hospitals'' that experience a

five percent decrease in discharges in one cost reporting period, as

compared to the previous period, due to unusual circumstances, beyond

its control, may request an adjustment to its Medicare payment amount.

Frequency: On occasion; Affected Public: Business or other for-profit,

Not-for-profit institutions, and State, local or tribal government;

Number of Respondents: 40; Total Annual Responses: 40; Total Annual

Hours Requested: 160.

2. Type of Information Collection Request: Reinstatement, with

change, of a previously approved collection for which approval has

expired; Title of Information Collection: Conditions of Participation

for Portable X-ray Suppliers (42 CFR 405 Subpart N); Form No.: HCFA-R-

43; Use: This information is needed to determine if portable X-ray

suppliers are in compliance with published health and safety

requirements. Frequency: Annually; Affected Public: Business or other-

for-profit; Number of Respondents: 554; Total Annual Responses: 554;

Total Annual Hours Requested: 1,385.

3. Type of Information Collection Request: Revision of a currently

approved collection; Title of Information Collection: Independent Rural

Health Center/Freestanding Federally Qualified Health Center Cost

Report; Form No.: HCFA-222; Use: The independent rural health clinic/

freestanding federally qualified health center cost report is the cost

report to be used by the mentioned clinics/centers to submit annual

information to achieve a settlement of costs for health care services

rendered to Medicare beneficiaries. Frequency: Annually; Affected

Public: Business or other for-profit, Not-for-profit institutions, and

State, local or tribal government; Number of Respondents: 3,000; Total

Annual Responses: 3,000; Total Annual Hours Requested: 120,000.

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: Louis Blank, Room C2-26-17, 7500 Security

Boulevard, Baltimore, Maryland 21244-1850.

[[Page 15487]]

Dated: March 19, 1996.

Kathleen B. Larson,

Director, Management Planning and Analysis Staff, Office of Financial

and Human Resources.

[FR Doc. 96-8532 Filed 4-5-96; 8:45 am]

BILLING CODE 4120-03-P