[Federal Register Volume 63, Number 103 (Friday, May 29, 1998)]
[Notices]
[Pages 29415-29416]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-14284]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-417]


Agency Information Collection Activities: Submission for OMB 
Review; 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: Hospice Request 
for Certification in the Medicare Program and Supporting Regulations in 
42 CFR 418.1-418.405; Form No.: HCFA-417 (OMB# 0938-0313); Use: The 
Hospice Request for Certification Form is used for hospice 
identification, screening, and to initiate the certification process. 
The information captured on this form is entered into a data base which 
assists HCFA in determining whether providers have sufficient personnel 
to participate in the Medicare program. The form summarizes data 
relative to: type of hospice; types of services provided by the 
hospice; and number of full time equivalents; Frequency: Annually; 
Affected Public: Business or other for-profit, Not-for-profit 
institutions, Federal Government, and State, local or tribal 
government; Number of Respondents: 2,286; Total Annual Responses: 
2,286; Total Annual Hours: 572.
    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 P<a href="/cdn-cgi/l/email-protection#e382938691948c9188a38b808582cd848c95"><span class="__cf_email__" data-cfemail="e584958097928a978ea58d868384cb828a93">[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 OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Allison Eydt, New 
Executive Office Building, Room 10235, Washington, D.C. 20503.


[[Page 29416]]


    Dated: May 19, 1998.
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. 98-14284 Filed 5-28-98; 8:45 am]
BILLING CODE 4120-03-P


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