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

[Document Identifier: HCFA-R-285]

Emergency Clearance: Public Information Collection Requirements

Submitted to the Office of Management and Budget (OMB)

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 summary of proposed collections for public

comment. Interested persons are invited to send comments regarding this

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.

We are, however, requesting an emergency review of the Information

collections referenced below. In compliance with the requirement of

section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have

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

requirements for emergency review. We are requesting an emergency

review because public harm is likely to occur if the information is not

collected. The beneficiaries affected by this legislation may be

eligible for free Part A as early as January 1998 if certain

requirements are met. One of the requirements is that the beneficiary's

retirement plan or former employer verify specific information before a

determination can be made regarding whether the beneficiary qualifies

for free Part A. Until a decision is made, the beneficiary must

continue to pay the monthly Part A premium of $309.00; therefore,

causing public harm.

HCFA is requesting OMB review and approval of this collection by 6/

15/99, with a 180-day approval period. Written comments and

recommendations will be accepted from the public if received by the

individuals designated below by 6/11/99. During this 180-day period, we

will publish a separate Federal Register notice announcing the

initiation of an extensive 60-day agency review and public comment

period on these requirements. We will submit the requirements for OMB

review and an extension of this emergency approval.

Type of Information Collection Request: New Collection;

Title of Information Collection: Request for Retirement Benefit

Information;

Form No.: HCFA-R-285 (OMB# 0938-NEW);

Use: This form will be used to obtain information regarding whether

a beneficiary is receiving retirement payments based on State or local

government employment, how long the claimant worked for the State or

local government employer, and whether the former employer or pension

plan subsidizes the beneficiary's Part A premium. The purpose in

collecting this information is to determine and provide those eligible

beneficiaries, with free Part A Medicare coverage.;

Frequency: On Occasion;

Affected Public: State, Local or Tribal Government, and Individuals

or Households;

Number of Respondents: 1500;

Total Annual Responses: 1500;

Total Annual Hours: 375.

To obtain copies of the supporting statement and any related forms

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

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

your request, including your address, phone number, 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 designees referenced below, by 6/11/99:

Health Care Financing Administration, Office of Information Services,

Security and Standards Group, Division of HCFA Enterprise Standards,

Attention: Dawn Willinghan, Room N2-14-26, 7500 Security Boulevard,

Baltimore, Maryland 21244-1850

and

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.

[[Page 27585]]

Date: May 12, 1999.

John Parmigiani,

Manager, HCFA Office of Information Services, Security and Standards

Group, Division of HCFA Enterprise Standards.

[FR Doc. 99-12731 Filed 5-19-99; 8:45 am]

BILLING CODE 4120-03-P