[Federal Register Volume 66, Number 86 (Thursday, May 3, 2001)]
[Notices]
[Pages 22242-22243]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-11118]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-18]


Agency Information Collection Activities: Proposed Collection; 
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.
    Type of Information Collection Request: Extension of a curently 
approved collection; Title of Information Collection Application for 
Hospital Insurance in 42 CFR 406.7; Form No.: HCFA-18 (OMB# 0938-0251); 
Use: The HCFA-18F5 is used to establish entitlement to hospital 
insurance and supplementary medical insurance for beneficiaries 
entitled under title XVIII of the Social Security Act; Frequency: On 
occasion; Affected Public: Individuals or households; Number of 
Respondents: 50,000; Total Annual Responses: 50,000; Total Annual 
Hours: 12,500.
    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

[[Page 22243]]

number, OMB number, and HCFA document identifier, to 
<a href="/cdn-cgi/l/email-protection#84d4e5f4e1f6f3ebf6efc4ece7e2e5aae3ebf2"><span class="__cf_email__" data-cfemail="ecbc8d9c899e9b839e87ac848f8a8dc28b839a">[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 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: Julie Brown, 
Attn: HCFA-18, Room N2-14-26, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: April 26, 2001.
John P. Burke, III,
Reports Clearance Officer, Security and Standards Group, Division of 
HCFA Enterprise Standards.
[FR Doc. 01-11118 Filed 5-2-01; 8:45 am]
BILLING CODE 4120-03-P


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