[Federal Register: April 10, 2001 (Volume 66, Number 69)]
[Notices]
[Page 18646-18647]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr10ap01-106]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-1500]
Agency Information Collection Activities: Submission for OMB
Review; 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 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;
[[Page 18647]]
(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 Request: Extension of a currently approved
collection; Title of Information Collection: Medicare/Medicaid Health
Insurance Common Claim Form, Instructions, and Supporting Regulations:
42 CFR 414.40, 424.32, 424.44; Form Number: HCFA-1500, HCFA-1490U,
HCFA-1490S (OMB approval #: 0938-0008); Use: This form is a
standardized form for use in the Medicare/Medicaid programs to apply
for reimbursement for covered services. In addition, it reduces cost
and administrative burdens associated with claims since only one coding
system is used and maintained; Frequency: On occasion; Affected Public:
Business or other for-profit, Not-for-profit institutions; Number of
Respondents: 1,321,417; Total Annual Responses: 1,321,417; Total Annual
Hours Requested: 44,189,007.
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, OMB number, and
HCFA document identifier, to Paperwork@hcfa.gov, or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 30 days of this notice directly to the OMB desk officer: OMB
Human Resources and Housing Branch, Attention: Wendy Taylor, New
Executive Office Building, Room 10235, Washington, DC 20503.
Dated: March 19, 2001.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services,
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 01-8730 Filed 4-9-01; 8:45 am]
BILLING CODE 4120-03-U