66376 Federal Register / Vol. 62, No. 243 / Thursday, December 18, 1997 / Notices

0193); Use: The HCFA–179 is used by

State agencies to transmit State plan

material to HCFA for approval prior to

amending their State plan. The State

Plan is the method in which States

inform staff of State policies, standards,

procedures and instructions; Frequency:

On occasion; Affected Public: State,

local and tribal government; Number of

Respondents: 57; Total Annual

Responses: 1,254; Total Annual Hours:

1,254.

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,

Information Technology Investment

Management Group, Division of HCFA

Enterprise Standards, Attention: Louis

Blank, Room C2–26–17, 7500 Security

Boulevard, Baltimore, Maryland 21244–

1850.

Dated: December 12, 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. 97–33067 Filed 12–17–97; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA–R–53]

Agency Information Collection

Activities: Proposed Collection;

Comment Request

AGENCY: Health Care Financing

Administration.

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: Extension of a currently

approved collection; Title of

Information Collection: Imposition of

Cost Sharing Charges Under Medicaid

and Supporting Regulations contained

in 42 CFR 447.53; Form No.: HCFA–R–

53 (OMB# 0938–0429); Use: The

information collection requirements

contained in 42 CFR 447.53 require the

States to include in their Medicaid State

Plan their cost sharing provisions for the

medically and categorically needy. The

State Plan is the method in which States

inform staff of State policies, standards,

procedures and instructions; Frequency:

Annually; Affected Public: State, Local

or Tribal Government; Number of

Respondents: 54; Total Annual

Responses: 54; Total Annual Hours:

2,700.

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,

Information Technology Investment

Management Group, Division of HCFA

Enterprise Standards, Attention: Louis

Blank, Room C2–26–17, 7500 Security

Boulevard, Baltimore, Maryland 21244–

1850.

Dated: December 10, 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. 97–33071 Filed 12–17–97; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[Form #HCFA–855]

Emergency Clearance: Public

Information Collection Requirements

Submitted to the Office of Management

and Budget (OMB)

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 (DHSS), has submitted

to the Office of Management and Budget

(OMB) the following request for

Emergency review. We are requesting an

emergency review because the

collection of this information is needed

prior to the expiration of the normal

time limits under OMB’s regulations at

5 C.F.R., Part 1320. The Agency cannot

reasonably comply with the normal

clearance procedures because a

statutory deadline imposed by the

Balanced Budget Act of 1997 (Pub. L.

105–33). Without this information,

HCFA would not be able to properly

implement the requirements set forth in

the statute.

HCFA is requesting OMB review and

approval of this collection by 12/31/97,

with a 180-day approval period. Written

comments and recommendations will be

accepted from the public if received by

the individual designated below, by 12/

29/97.

During this 180-day period HCFA will

pursue OMB clearance of this collection

as stipulated by 5 CFR. 1320.5.

1. Type of Information Collection

Request: Revision of a currently

approved collection; Title of

Information Collection: Medicare and

Other Federal Health Care Program

Providers/Supplier Enrollment

Application; Form No.: HCFA–855,

HCFA–855C, HCFA–855R, HCFA–855S;

Use: This information is needed to

enroll providers and suppliers into the

Medicare program by identifying them,

and verifying their qualifications and

eligibility to participate in Medicare,

and to price and pay their claims.;

Frequency: Initial Enrollment/

Recertification; Affected Public:

Business or other for-profit, individuals

or households, not-for-profit

institutions, and Federal Government;

Number of Respondents: 225,000; Total

Annual Responses: 225,000; Total

Annual Hours: 435,000.

To obtain copies of the supporting

statement and any related forms for the

proposed paperwork collections

referenced above, access HCFA’s Web
Federal Register / Vol. 62, No. 243 / Thursday, December 18, 1997 / Notices 66377

Site address at http://www.hcfa.gov/

regs/prdact95.htm, or E-mail your

request, including your address, phone

number, and HCFA form number(s)

referenced above, to

Paperwork@hcfa.gov, or call the Reports

Clearance Office on (410) 786–1326.

Interested persons are invited to send

comments regarding the burden or any

other aspect of these collections of

information requirements. However, as

noted above, comments on these

information collection and

recordkeeping requirements must be

mailed and/or faxed to the designee

referenced below, by 12/29/97: Office of

Information and Regulatory Affairs,

Office of Management and Budget,

Room 10235, New Executive Office

Building, Washington, DC 20503, Fax

Number: (202) 395–6974 or (202) 395–

5167 Attn: Allison Herron Eydt, HCFA

Desk Officer.

Dated: December 12, 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. 97–33066 Filed 12–17–97; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Office of Inspector General

Program Exclusions: November 1997

AGENCY: Office of Inspector General,

HHS.

ACTION: Notice of program exclusions.

During the month of November 1997,

the HHS Office of Inspector General

imposed exclusions in the cases set

forth below. When an exclusion is

imposed, no program payment is made

to anyone for any items or services

(other than an emergency item or

service not provided in a hospital

emergency room) furnished, ordered or

prescribed by an excluded party under

the Medicare, Medicaid, Maternal and

Child Health Services Block Grant and

Block Grants to States for Social

Services programs. In addition, no

program payment is made to any

business or facility, e.g., a hospital, that

submits bills for payment for items or

services provided by an excluded party.

Program beneficiaries remain free to

decide for themselves whether they will

continue to use the services of an

excluded party even though no program

payments will be made for items and

services provided by that excluded

party. The exclusions have national

effect and also apply to all Executive

Branch procurement and nonprocurement programs and activities.

Subject, city, state Effective date

PROGRAM-RELATED CONVICTIONS

ARBAUGH, CHARLES B, W PALM BEACH, FL ................................................................................................................................ 12/18/1997

BARNARD, KEITH L, BROOKLYN, NY .............................................................................................................................................. 12/18/1997

BONANNO, STEVEN, BROOKLYN, NY ............................................................................................................................................. 12/18/1997

BONE, DONALD RAY, LITTLE ROCK, AR ........................................................................................................................................ 12/18/1997

BORGES, ALFREDO LAZARO JR, EGLIN AFB, FL .......................................................................................................................... 12/18/1997

CABRERA, JUAN, PLANDOME HEIGHTS, NY ................................................................................................................................. 12/18/1997

CHERKAS, MARK W, YARDLEY, PA ................................................................................................................................................. 12/18/1997

FOLSE, NADINE M, RACELAND, LA ................................................................................................................................................. 12/18/1997

FOSTER, RAMONA, CAROLINA, RI .................................................................................................................................................. 12/18/1997

FRAZIER, JAMES, OAK PARK, MI ..................................................................................................................................................... 12/18/1997

GONZALEZ, PEDRO LEONARDO, MIRAMAR, FL ............................................................................................................................ 12/18/1997

HOWARD, LINDA J, CHEPACHET, RI ............................................................................................................................................... 12/18/1997

HUDSON, LOVEY LEE, JACKSONVILLE, AR ................................................................................................................................... 12/18/1997

IRVING, LEWIS M JR, BRIDGETON, NJ ........................................................................................................................................... 12/18/1997

LAMBERT, DIANNA, BRYAN, TX ....................................................................................................................................................... 12/18/1997

LAWRENCE, THOMAS JAMES, WAYNESVILLE, MO ...................................................................................................................... 12/18/1997

LEE, STEVEN K, LAFAYETTE HILL, PA ............................................................................................................................................ 12/18/1997

MCDONALD, J T, LITTLE ROCK, AR ................................................................................................................................................ 12/18/1997

MCKENZIE, MARIE, WHEATLEY HGHTS, NY .................................................................................................................................. 12/18/1997

MER, EVGENYA, SHARON SPRINGS, NY ....................................................................................................................................... 12/18/1997

OVERTON, PAMELA SALERNO, NEW HAVEN, CT ......................................................................................................................... 12/18/1997

RODRIQUEZ, SONIA, NEW YORK, NY ............................................................................................................................................. 12/18/1997

ROWELL, GEORGE P, DELANO, CA ................................................................................................................................................ 12/18/1997

SCHUSTER, STANLEY, ANN ARBOR, MI ......................................................................................................................................... 12/18/1997

STAGGER, ROBERT W, UPPER SANDUSKY, OH ........................................................................................................................... 12/18/1997

STEVEN LEE, INC, LAFAYETTE HILL, PA ........................................................................................................................................ 12/18/1997

TAING, SOPHY, POMONA, CA .......................................................................................................................................................... 12/18/1997

TARAWALY, TEJAN, OREGON, WI ................................................................................................................................................... 12/18/1997

THOMAS, SHARMAINE, AUSTIN, MN ............................................................................................................................................... 12/18/1997

VIDU, DORIAN M, CLEVELAND, OH ................................................................................................................................................. 12/18/1997

WEATHERLY, BILLY WAYNE, FORREST CITY, AR ........................................................................................................................ 12/18/1997

YANEZ-LEMIRE, FAITH, GOFFSTOWN, NH ..................................................................................................................................... 12/18/1997

ZWEIG, MARK ALAN, BOSSIER CITY, LA ........................................................................................................................................ 12/18/1997

PATIENT ABUSE/NEGLECT CONVICTIONS

BLOOM, RICHARD M, BROOKLINE, MA ........................................................................................................................................... 12/18/1997

BUTLER, HENRY, NOBLE, IL ............................................................................................................................................................. 12/18/1997

CACIOPPO, DINO T, SAN LEANDRO, CA ........................................................................................................................................ 12/18/1997

CICHON, DANIEL FRANK, OSHKOSH, WI ........................................................................................................................................ 12/18/1997

COLLINS, ANN, BEVERLY, MA .......................................................................................................................................................... 12/18/1997

CROWLEY, JENNIFER LENAE, SWISHER, IA .................................................................................................................................. 12/18/1997

FREDERICK, JANENE L, ST LOUIS, MO .......................................................................................................................................... 12/18/1997

GRIFFIN, MICHAEL JAMES, OSAWATOMIE, KS ............................................................................................................................. 12/18/1997

LOPEZ, ADAM, LOVINGTON, NM ...................................................................................................................................................... 12/18/1997