[Federal Register: March 16, 2001 (Volume 66, Number 52)]
[Notices]
[Page 15264]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr16mr01-47]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-10028]
Agency Information Collection Activities: Proposed Collection;
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; (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: New collection; Title of
Information Collection: State Health Insurance Assistance Program
(SHIP) Client Contact Form; Form No.: HCFA-10028 (OMB# 0938-NEW); Use:
The State Health Insurance Assistance Program (SHIP) Client Contact
Form will be completed by SHIP counselors at each counseling event to
collect SHIP performance data, which will then be accumulated and
analyzed to measure performance; Frequency: Semi-annually, Annually;
Affected Public: State, local, or tribal gov.; Number of Respondents:
53; Total Annual Responses: 265; Total Annual Hours: 159. 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 60 days of this notice directly to the HCFA Paperwork Clearance
Officer designated at the following address: HCFA, Office of
Information Services, Security and Standards Group, Division of HCFA
Enterprise Standards, Attention: Julie Brown, HCFA 10028, Room N2-14-
26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: March 7, 2001.
John P. Burke III,
Reports Clearance Officer, Security and Standards Group, Division of
HCFA Enterprise Standards.
[FR Doc. 01-6512 Filed 3-15-01; 8:45 am]
BILLING CODE 4120-03-P