34904 Federal Register / Vol. 63, No. 123 / Friday, June 26, 1998 / Notices

accomplishing this linkage no later than

July 15, 1998.

After plans have established linkages

to a FI, hospitals will submit HCFA–

1450 (UB–92) forms to the managed care

plan. The HCFA–1450 (UB–92) form is

identical to the one used by hospitals in

billing for Medicare fee-for-service

claims. After receiving the pseudo claim

from the hospital, the plan attaches the

plan identifier, which is the HCFA

assigned managed care organization

(MCO) Contract Number, and submits

the pseudo-claim electronically to the

fiscal intermediary (FI). The data

processing flow by the FI is very similar

to current claims processing for the feefor-service system, except that no

payment is authorized to the plan.

Pseudo claims will flow though the FI

to our Common Working File (CWF) and

will be retained by HCFA.; Frequency:

On occasion; Affected Public: Business

or other for-profit, Not-for-profit

institutions, and Federal government;

Number of Respondents: 1.9 million;

Total Annual Responses: 1.9 million;

Total Annual Hours: 32,833.

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,

Security and Standards Group, Division

of HCFA Enterprise Standards,

Attention: Louis Blank, Room C2–26–

17, 7500 Security Boulevard, Baltimore,

Maryland 21244–1850.

Dated: June 16, 1998.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA Office

of Information Services, Security and

Standards Group, Division of HCFA

Enterprise Standards.

[FR Doc. 98–16989 Filed 6–25–98; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA–R–243]

Agency Information Collection

Activities: Proposed Collection;

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, is publishing the

following summary of proposed

collections for public comment.

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: New Collection; Title of

Information Collection: Medicare

Agreement Application, Health Care

Prepayment Plan; Form No.: HCFA–R–

243; Use: An organization must meet

certain requirements to be a Health Care

Prepayment Plan that is eligible for a

Medicare 1833 agreement. The

application is the collection form used

to obtain information from an

organization that would allow HCFA

staff to determine compliance with the

regulations. This form includes requests

for information about: the management

of the applicant organization;

arrangements for providing health care

to beneficiaries; meeting Medicare

requirements for appeals, hearings,

advance directives, health benefits; risk

sharing with other entities; the fiscal

soundness of the applicant; the cost

budget, which forms the basis for HCFA

payment; prevention of duplicate

payment; and the applicant’s marketing

strategy. Frequency: One time ; Affected

Public: Business or other for-profit

institutions, Not-for-profit institutions,

and State, Local or Tribal Governments.;

Number of Respondents: 15; Total

Annual Responses: 15; Total Annual

Hours: 1,125.

To obtain copies of the supporting

statement for the proposed paperwork

collections referenced above, or any

related forms, E-mail your request,

including your address and phone

number, 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: John

Rudolph, Room C2–26–17, 7500

Security Boulevard, Baltimore,

Maryland 21244–1850.

Dated: June 18, 1998.

John P. Burke III,

HCFA Reports Clearance Officer, Division of

HCFA Enterprise Standards, Health Care

Financing Administration.

[FR Doc. 98–16999 Filed 6–25–98; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Agency Information Collection

Activities: Proposed Collection:

Comment Request

In compliance with the requirement

for opportunity for public comment on

proposed data collection projects

(section 3506(c)(2)(A) of Title 44, United

States Code, as amended by the

Paperwork Reduction Act of 1995, Pub.

L. 104–13), the Health Resources and

Services Administration (HRSA) will

publish periodic summaries of proposed

projects being developed for submission

to OMB under the Paperwork Reduction

Act of 1995. To request more

information on the proposed project or

to obtain a copy of the data collection

plans and draft instruments, call the

HRSA Reports Clearance Officer on

(301) 443–1891.

Comments are invited on: (a) whether

the proposed collection of information

is necessary for the proper performance

of the functions of the agency, including

whether the information shall have

practical utility; (b) the accuracy of the

agency’s estimate of the burden of the

proposed collection of information; (c)

ways to enhance the quality, utility, and

clarity of the information to be

collected; and (d) ways to minimize the

burden of the collection of information

on respondents, including through the

use of automated collection techniques

or other forms of information

technology.