[Federal Register Volume 63, Number 136 (Thursday, July 16, 1998)]
[Notices]
[Pages 38413-38414]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-19003]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-116, HCFA-416, HCFA-R-148, and HCFA-R-231]


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

AGENCY: Health Care Financing Administration, HHS.
    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.
    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Clinical 
Laboratory Improvement Amendments (CLIA) Application Form and 
Supporting Regulations in 42 CFR 493.1--.2001; Form No.: HCFA-116 (OMB# 
0938-0581); Use: These certification requirements have been established 
for any entity that performs testing on human beings for diagnostic or 
treatment purposes. If a laboratory conducts relatively simple tests 
that are categorized as waived or provider performed microscopy test 
procedures (PPMP), it must obtain a certificate of waiver or 
certificate of PPMP. If the laboratory conducts any tests outside of 
these two categories, it must apply for a certificate of compliance or 
certificate of accreditation and initially obtain a registration 
certificate. These certificates ensure that laboratories are in 
compliance with CLIA.; Frequency: Biennially; Affected Public: Business 
or other for profit, Not for profit institutions, Federal Government, 
and State, local or tribal government; Number of Respondents: 16,000; 
Total Annual Responses: 16,000; Total Annual Hours: 20,000.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Annual Early and 
Periodic Screening, Diagnostic, and Treatment Services (EPSDT) 
Participation Report and Supporting Regulations in 42 CFR 441.60; Form 
No.: HCFA-416 (OMB# 0938-0354); Use: States are required to submit an 
annual report on the provision of EPSDT services to HCFA pursuant to 
section 1902(a)(43) of the Social Security Act. These reports provide 
HCFA with data necessary to assess the effectiveness of State EPSDT 
programs. It is also helpful in developing trend patterns, national 
projections, responding to inquiries, and determining a State's results 
in achieving its participation goal.; Frequency: Annually; Affected 
Public: State, Local or Tribal Government; Number of Respondents: 56; 
Total Annual Responses: 56; Total Annual Hours: 1,568.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Limitation on 
Provider-Related Donations and Health Care-Related Taxes; Limitations 
on Payments to Disproportionate Share Hospitals; Medicaid and 
Supporting Regulations in 42 CFR 433.68, 433.74, 447.74 and 447.272; 
Form No.: HCFA-R-148 (OMB# 0938-0618); Use: These information 
collection requirements specify limitations on the amount of Federal 
financial participation available for medical assistance expenditures 
in a fiscal year. States receive donated funds from providers and 
revenues are generated by health care related taxes. These donations 
and revenues are used to fund medical assistance programs.; Frequency: 
Quarterly; Affected Public: State, Local, or Tribal Government; Number 
of Respondents: 51; Total Annual Responses: 51; Total Annual Hours: 
#3,892.
    4. Type of Information Request: Revision of a currently approved 
collection; Title of Information

[[Page 38414]]

Collection: Medicare+Choice (M+C) Providers Sponsored Organization 
(PSO) Waiver Request Form and Supporting Regulations in 42 CFR 422.370-
422.378; Form Number: HCFA-R-231; Use: The PSO waiver request form is 
for use by PSO's that do not have a State risk-bearing entity licence 
and that wish to enter into a M+C contract with HCFA to provide prepaid 
health care services to eligible Medicare beneficiaries. HCFA will use 
the information requested on this form to determine whether the 
applicant is eligible for a waiver of the state licensure requirement 
for M+C organizations as allowed under section 1855(a)(2) of the Social 
Security Act.; Frequency: One-time.; Affected Public: Business or other 
for-profit, Not-for-profit institutions, and Federal Government.; 
Annual Number of Respondents: 30.; Total Annual Responses: 30.; Total 
Annual Hours Requested: 300.
    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#f7968792858098859cb79f949196d9909881"><span class="__cf_email__" data-cfemail="88e9f8edfaffe7fae3c8e0ebeee9a6efe7fe">[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.

    Dated: July 9, 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. 98-19003 Filed 7-15-98; 8:45 am]
BILLING CODE 4120-03-P


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