[Federal Register Volume 60, Number 52 (Friday, March 17, 1995)]
[Notices]
[Pages 14435-14436]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-6553]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration


Public Information Collection Requirements Submitted to the 
Office of Management and Budget (OMB) for Clearance

AGENCY: Health Care Financing Administration, HHS. The Health Care 
Financing Administration (HCFA), Department of Health and Human 
Services, has submitted to OMB the following proposals for the 
collection of information in compliance with the Paperwork Reduction 
Act (Pub. L. 96-511).
    1. Type of Request: New Collection;
    Title of Information Collection: Medicaid Drug Rebate--Remittance 
Advice Report;
    Form No.: HCFA-304;
    Use: The Omnibus Budget Reconciliation Act of 1990 requires drug 
manufacturers to enter into and have in effect a rebate agreement with 
HCFA for States to receive funding for drugs dispensed to Medicaid 
recipients. The regulations at 42 CFR 447.534 and 447.536 require 
manufacturers to report specific drug rebate information to States when 
payment is made;
    Respondents: Business or other for profit;
    Number of Respondents: 482;
    Total Annual Responses: 1,928;
    Total Annual Hours Requested: 116,896.
    2. Type of Request: Reinstatement;
    Title of Information Collection: Termination of Enrollment 
Regulation--BPD-306;
    Form No.: HCFA-141;
    Use: The termination of enrollment requirement allows States, 
through contracts with Federally Qualified Health Maintenance 
Organizations (HMO) and certain other managed care contracts to 
restrict disenrollment from an HMO up to a 6-month period. However, 
Medicaid beneficiaries are allowed to disenroll during the period for 
good cause;
    Respondents: Business or other for profit, State or local 
government;
    Number of Respondents: 60,214;
    Total Annual Responses: 1;
    Total Annual Hours Requested: 15,054.
    3. Type of Request: Reinstatement;
    Title of Information Collection: Information Collection Requirement 
at [[Page 14436]] 42 CFR 447.53(d) Imposition of Cost Sharing Charges 
Under Medicaid (BERC-509);
    Form No.: HCFA-R53;
    Use: The information collection requirement at 42 CFR 447.53(d) 
requires the States to include in their Medicaid State plan their 
provisions for imposition of cost sharing on the medically and 
categorically needy;
    Respondents: State or local government;
    Number of Respondents: 54;
    Total Annual Responses: 54;
    Total Annual Hours Requested: 2,700.
    4. Type of Request: Reinstatement;
    Title of Information Collection: Medicare Current Beneficiary 
Survey--Community Component Supplement PR: ``Sources Of Information 
About Medicare'';
    Form No.: HCFA-P-0015A;
    Use: This supplement is intended to find out from a systematic 
sample of Medicare beneficiaries, how they obtain information about 
program rules and procedures when they need it. It also elicits their 
opinion of the adequacy of the information they found, and alternative 
means by which HCFA might provide this information;
    Respondents: Individuals and households;
    Number of Respondents: 12,000;
    Total Annual Responses: 12,000;
    Total Annual Hours Requested: 2,000.
    5. Type of Request: Reinstatement;
    Title of Information Collection: Application for Hospital 
Insurance;
    Form No.: HCFA-18;
    Use: This form is used to establish entitlement to Hospital 
Insurance and Supplementary Medical Insurance for beneficiaries covered 
under only title XVIII of the Social Security Act;
    Respondents: Business or other for profit, Federal Government, 
State or local government, farms, individuals and households;
    Number of Respondents: 50,000;
    Total Annual Responses: 50,000;
    Total Annual Hours Requested: 12,500.
    Additional Information or Comments: Call the Reports Clearance 
Office on (410) 966-5536 for copies of the clearance request packages. 
Written comments and recommendations for the proposed information 
collections should be sent within 30 days of this notice directly to 
the OMB Desk Officer designated at the following address: OMB Human 
Resources and Housing Branch, Attention: Allison Eydt, New Executive 
Office Building, Room 10235, Washington, DC 20503.

    Dated: March 7, 1995.
Kathleen B. Larson,
Director, Management Planning and Analysis Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 95-6553 Filed 3-16-95; 8:45 am]
BILLING CODE 4120-03-P