Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB)

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Form #HCFA-855]

Emergency Clearance: Public Information Collection Requirements

Submitted to the Office of Management and Budget (OMB)

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 (DHSS),

has submitted to the Office of Management and Budget (OMB) the

following request for Emergency review. We are requesting an emergency

review because the collection of this information is needed prior to

the expiration of the normal time limits under OMB's regulations at 5

C.F.R., Part 1320. The Agency cannot reasonably comply with the normal

clearance procedures because a statutory deadline imposed by the

Balanced Budget Act of 1997 (Pub. L. 105-33). Without this information,

HCFA would not be able to properly implement the requirements set forth

in the statute.

HCFA is requesting OMB review and approval of this collection by

12/31/97, with a 180-day approval period. Written comments and

recommendations will be accepted from the public if received by the

individual designated below, by 12/29/97.

During this 180-day period HCFA will pursue OMB clearance of this

collection as stipulated by 5 CFR. 1320.5.

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

approved collection; Title of Information Collection: Medicare and

Other Federal Health Care Program Providers/Supplier Enrollment

Application; Form No.: HCFA-855, HCFA-855C, HCFA-855R, HCFA-855S; Use:

This information is needed to enroll providers and suppliers into the

Medicare program by identifying them, and verifying their

qualifications and eligibility to participate in Medicare, and to price

and pay their claims.; Frequency: Initial Enrollment/Recertification;

Affected Public: Business or other for-profit, individuals or

households, not-for-profit institutions, and Federal Government; Number

of Respondents: 225,000; Total Annual Responses: 225,000; Total Annual

Hours: 435,000.

To obtain copies of the supporting statement and any related forms

for the proposed paperwork collections referenced above, access HCFA's

Web

[[Page 66377]]

Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail your

request, including your address, phone number, and HCFA form number(s)

referenced above, to P[email protected], or call the Reports Clearance

Office on (410) 786-1326.

Interested persons are invited to send comments regarding the

burden or any other aspect of these collections of information

requirements. However, as noted above, comments on these information

collection and recordkeeping requirements must be mailed and/or faxed

to the designee referenced below, by 12/29/97: Office of Information

and Regulatory Affairs, Office of Management and Budget, Room 10235,

New Executive Office Building, Washington, DC 20503, Fax Number: (202)

395-6974 or (202) 395-5167 Attn: Allison Herron Eydt, HCFA Desk

Officer.

Dated: December 12, 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. 97-33066 Filed 12-17-97; 8:45 am]

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