[Federal Register Volume 69, Number 243 (Monday, December 20, 2004)]
[Notices]
[Pages 75984-75985]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-27705]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-238]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare and Medicaid Services, HHS.
    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: Inpatient 
Psychiatric Services for Individuals Under Age 21 and Supporting 
Regulations in 42 CFR Section 441.151 and 441.152; Use: Certification 
requirements in 42 CFR 441.151 and 441.152 require that if it is 
determined that psychiatric services in an inpatient setting for 
individuals under age 21 are necessary, certification must be in 
writing before an individual is admitted for treatment. This 
information is used by States to document that effective screening 
measures are in place to justify the use of inpatient psychiatric 
services; Form Number: CMS-R-238 (OMB<greek-i>: 0938-0754); Frequency: 
Recordkeeping; Affected Public: State, Local or Tribal Govt., Business 
or other for-profit, and Not-for-profit institutions; Number of 
Respondents: 80,000; Total Annual Responses: 80,000; Total Annual 
Hours: 1.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS's 
Web site

[[Page 75985]]

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#184879687d6a6f776a73587b756b3670706b367f776e"><span class="__cf_email__" data-cfemail="91c1f0e1f4e3e6fee3fad1f2fce2bff9f9e2bff6fee7">[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 Reduction Act Reports Clearance Officer designated at 
the address below:
    CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Melissa Musotto, Room 
C5-14-03, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: December 8, 2004.
John P. Burke, III,
CMS Paperwork Reduction Act Reports Clearance Officer, Office of 
Strategic Operations and Regulatory Affairs Regulations Development 
Group.
[FR Doc. 04-27705 Filed 12-17-04; 8:45 am]
BILLING CODE 4120-03-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>