[Federal Register Volume 62, Number 163 (Friday, August 22, 1997)]
[Notices]
[Page 44701]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-22343]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-255]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    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, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal for the collection of information. Interested persons are 
invited to send comments regarding the 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: Extension of a currently 
approved collection; Title of Information Collection: Municipal Health 
Services Cost Report Form, and supporting regulations 42 CFR 405.371; 
Form No.: HCFA-255; Use: The Municipal Health Services Program (MHSP) 
Cost Report (HCFA-255) is used by the participating MHSP clinics to 
report costs for health care services rendered to Medicare 
beneficiaries. It is also used to gather data to properly evaluate the 
MHSP demonstration. This form has been used since 1979. Frequency: 
Annually; Affected Public: Not-for-profit institutions, and State, 
Local or Tribal Government; Number of Respondents: 14; Total Annual 
Responses: 14; Total Annual Hours: 476.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, access HCFA's WEB SITE ADDRESS 
at http://www.hcfa.gov/regs/prdact95.htm, or to obtain the supporting 
statement and any related forms, E-mail your request, including your 
address and phone number, to P<a href="/cdn-cgi/l/email-protection#a2c3d2c7d0d5cdd0c9e2cac1c4c38cc5cdd4"><span class="__cf_email__" data-cfemail="0f6e7f6a7d78607d644f676c696e21686079">[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 30 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address: OMB Human Resources and 
Housing Branch, Attention: Allison Eydt, New Executive Office Building, 
Room 10235, Washington, DC 20503.

    Dated: August 8, 1997.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Information Technology Investment Management Group, Division of HCFA 
Enterprise Standards.
[FR Doc. 97-22343 Filed 8-21-97; 8:45 am]
BILLING CODE 4120-03-P


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