Agency Information Collection Activities: Proposed Collection; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-265]

Agency Information Collection Activities: Proposed Collection;

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, is

publishing the following summary of proposed collections 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.

Type of Information Collection Request: Reinstatement without

change of a previously approved collection for which approval has

expired; Title of Information Collection: Independent Renal Dialysis

Facility Cost Report Form and Supporting Regulations 42 CFR 413.198,

413.20; Form No.: HCFA-265; Use: The Medicare Independent Renal

Dialysis Facility Cost Report provides for determinations and

allocation of costs to the components of the Renal Dialysis facility in

order to establish a proper basis for Medicare payment. Frequency:

Annually; Affected Public: Business or other for profit; Number of

Respondents: 2,472; Total Annual Responses: 2,472; Total Annual Hours:

484,512.

2. Type of Information Collection Request: New Collection; Title of

Information Collection: Evaluation of the Oregon Medicaid Reform

Demonstration: Phase II Adult Interview, Phase II Child Interview,

Survey of Agency Providers; Form No.: HCFA-R-221; Use: These survey

instruments will be used to evaluate the Oregon Medicaid Reform

Demonstration. The Phase II Adult and Phase II Child interviews are

designed to collect information on health status, access to care and

past health insurance status for adults and children participating in

Phase II of the Oregon Health Plan (OHP). The survey of Agency

providers is designed to collect information on the experience under

OHP of agencies that traditionally treat disabled and elderly Medicaid

beneficiaries. Frequency: One Time; Affected Public: Individuals or

Households, Business or other for-profit, Not-for-profit institutions,

and State, Local or Tribal Governments; Number of Respondents: 4,150;

Total Annual Responses: 4,150; Total Annual Hours: 1,730.

3. Type of Information Collection Request: Reinstatement, without

change, of a previously approved collection for which approval has

expired; Title of Information Collection: Health Maintenance

Organizations & Competitive Medical Plans National Data Reporting

Requirements and Supporting Regulations 42 CFR 417.100, .940, .126,

.478, .162; Form No.: HCFA-906; Use: This form captures information

which governs qualification of new Health Maintenance Organizations

(HMOs) and the eligibility of Competitive Medical Plans (CMPs),

employer compliance, recovery of Federal loan and loan guarantees,

financial disclosure, and continuing regulation of qualified HMOs and

CMPs which provide health care services to beneficiaries for a fixed

fee which is paid on a periodic basis. Frequency: Other; Annually,

Quarterly; Affected Public: Federal Government, Business or other for-

profit, Not-for-profit institutions, State, local or Tribal Government;

Number of Respondents: 313; Total Annual Responses: 953; Total Annual

Hours: 3,130.

To obtain copies of the supporting statement for the proposed

paperwork collections referenced above, or 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 within 60 days of this notice directly to

the HCFA Paperwork Clearance Officer designated at the following

address: HCFA, Office of Information Services, Information Technology

Investment Management Group, Division of HCFA Enterprise Standards,

Attention: John Rudolph, Room C2-26-17, 7500 Security Boulevard,

Baltimore, Maryland 21244-1850.

Dated: December 11, 1997.

John P. Burke III,

HCFA Reports Clearance Officer, Division of HCFA Enterprise Standards,

Health Care Financing Administration.

[FR Doc. 97-33064 Filed 12-17-97; 8:45 am]

BILLING CODE 4120-03-P