[Federal Register: March 18, 2005 (Volume 70, Number 52)]
[Notices]
[Page 13216-13217]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18mr05-108]

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RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

SUMMARY: In accordance with the requirement of Section 3506(c)(2)(A) of

[[Page 13217]]

the Paperwork Reduction Act of 1995 which provides opportunity for
public comment on new or revised data collections, the Railroad
Retirement Board (RRB) will publish periodic summaries of proposed data
collections.
    Comments are invited on: (a) Whether the proposed information
collection is necessary for the proper performance of the functions of
the agency, including whether the information has practical utility;
(b) the accuracy of the RRB's estimate of the burden of the collection
of the information; (c) ways to enhance the quality, utility, and
clarity of the information to be collected; and (d) ways to minimize
the burden related to the collection of information on respondents,
including the use of automated collection techniques or other forms of
information technology.

Title and Purpose of Information Collection

    Application for Reimbursement for Hospital Insurance Services in
Canada; OMB 3220-0086. Under section 7(d) of the Railroad Retirement
Act (RRA), the RRB administers the Medicare program for persons covered
by the railroad retirement system. Payments are provided under section
7(d)4) of the RRA for medical services furnished in Canada to the same
extent as for those furnished in the United States. However, payments
for the services furnished in Canada are made from the Railroad
Retirement Account rather than from the Federal Hospital Insurance
Trust Fund, with the payments limited to the amount by which insurance
benefits under Medicare exceed the amounts payable under Canadian
Provincial plans.
    Form AA-104, Application for Canadian Hospital Benefits Under
Medicare--Part A, is provided by the RRB for use in claiming benefits
for covered hospital services received in Canada. The form obtains
information needed to determine eligibility for, and the amount of any
reimbursement due the applicant. One response is requested of each
respondent. Completion is required to obtain a benefit.
    No changes are proposed to Form AA-104.
    Number of respondents: 50.
    Estimated completion time: 10 minutes.
    Estimated annual burden hours: 8.
    Additional Information or Comments: To request more information or
to obtain a copy of the information collection justification, forms,
and/or supporting material, please call the RRB Clearance Officer at
(312) 751-3363 or send an e-mail request to Charles.Mierzwa@RRB.GOV.
Comments regarding the information collection should be addressed to
Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street,
Chicago, Illinois 60611-2092 or send an e-mail to 
Ronald.Hodapp@RRB.GOV. Written comments should be received within 60

days of this notice.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 05-5419 Filed 3-17-05; 8:45 am]

BILLING CODE 7905-01-P