[Federal Register Volume 69, Number 214 (Friday, November 5, 2004)]
[Notices]
[Page 64575]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-24781]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicine and Medicaid Services

[Document Identifier: CMS-R-306 and CMS-R-148]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    Agency: Centers for Medicare and Medicaid Services.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid 
Services (CMS) (formerly known as 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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Restraint and 
Seclusion Standards for Psychiatric Residential Treatment Facilities; 
Use: Psychiatric residential treatment facilities are required to 
report deaths, serious injuries and attempted suicides to State 
Medicaid Agency and Protection and Advocacy Organization. They are also 
required to provide residents restraint and seclusion policy in 
writing, and to document resident record of all activities involving 
use of restraint and seclusion. Form Number: CMS-R-306 (OMB<greek-i>: 
0938-0833); Frequency: On occasion; Affected Public: Business or other 
for-profit and Not-for-profit institutions; Number of Respondents: 500; 
Total Annual Responses: 2,600,000; Total Annual Hours: 877,750.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Limitations on 
Provider Related Donations and Health Care Related Taxes; Limitation on 
payments to Disproportionate Share Hospitals; Medicaid and Supporting 
Regulations in 42 CFR 433.68, 433.74, and 447.272.; Use: This 
information collection is necessary to ensure compliance with Sections 
1903 and 1923 of the Social Security Act for the purpose of preventing 
payment of federal financial participation on amounts prohibited by the 
statute. Form Number: CMS-R-148 (OMB<greek-i>: 0938-0618); Frequency: 
Quarterly; Affected Public: State, Local or Tribal Gov't; Number of 
Respondents: 50; Total Annual Responses: 40; Total Annual Hours: 3,200.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web Site address at http://www.cms.hhs.gov/regulations/pra/, or E-mail 
your request, including your address, phone number, OMB number, and CMS 
document identifier, to <a href="/cdn-cgi/l/email-protection#7c2c1d0c190e0b130e173c1f110f5214140f521b130a"><span class="__cf_email__" data-cfemail="287849584d5a5f475a43684b455b0640405b064f475e">[email protected]</span></a>, 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 CMS Paperwork Clearance Officer designated at the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development and Issuances, Attention: Melissa 
Musotto, Room C5-14-03, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

    Dated: October 28, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, Office of Strategic Operations and 
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 04-24781 Filed 11-4-04; 8:45 am]
BILLING CODE 4120-03-M


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