[Federal Register Volume 74, Number 140 (Thursday, July 23, 2009)]
[Notices]
[Page 36539]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-17509]


=======================================================================
-----------------------------------------------------------------------

RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

    Summary: In accordance with the requirement of Section 3506 
(c)(2)(A) of the Paperwork Reduction Act of 1995 which provides 
opportunity for public comment on new or revised data collections, the 
Railroad Retirement Board (RRB) will publish periodic summaries of 
proposed data collections.
    Comments are invited on: (a) Whether the proposed information 
collection is necessary for the proper performance of the functions of 
the agency, including whether the information has practical utility; 
(b) the accuracy of the RRB's estimate of the burden of the collection 
of the information; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden related to the collection of information on respondents, 
including the use of automated collection techniques or other forms of 
information technology.
    Title and Purpose of information collection: Request for Medicare 
Payment; OMB 3220-0131.
    Under Section 7(d) of the Railroad Retirement Act, the RRB 
administers the Medicare program for persons covered by the railroad 
retirement system. The collection obtains the information needed by 
Palmetto GBA, the Medicare carrier for railroad retirement 
beneficiaries, to pay claims for payments under Part B of the Medicare 
program. Authority for collecting the information is prescribed in 42 
CFR 424.32.
    The RRB currently utilizes Forms G-740S, Patient's Request for 
Medicare Payment, (along with Centers for Medicare and Medicaid 
Services Form CMS-1500) to secure the information necessary to pay Part 
B Medicare Claims. One response is completed for each claim. Completion 
is required to obtain a benefit. The RRB proposes minor, non-burden 
impacting editorial changes to RRB Form G-740S. The RRB estimates 
annual respondent burden associated with RRB Form G-740s as follows:
    Estimated number of responses: 100.
    Estimated completion time per response: 15 minutes.
    Estimated annual burden hours: 25.
    Additional Information or Comments: To request more information or 
to obtain a copy of the information collection justification, forms, 
and/or supporting material, please call the RRB Clearance Officer at 
(312) 751-3363 or send an e-mail request to <a href="/cdn-cgi/l/email-protection#99daf1f8ebf5fceab7d4f0fcebe3eef8d9cbcbdbb7ded6cf"><span class="__cf_email__" data-cfemail="eead868f9c828b9dc0a3878b9c94998faebcbcacc0a9a1b8">[email protected]</span></a>. 
Comments regarding the information collection should be addressed to 
Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois 60611-2092 or send an e-mail to 
<a href="/cdn-cgi/l/email-protection#91c3fefff0fdf5bfd9fef5f0e1e1d1c3c3d3bfd6dec7"><span class="__cf_email__" data-cfemail="40122f2e212c246e082f24213030001212026e070f16">[email protected]</span></a>. Written comments should be received within 60 
days of this notice.

Charles Mierzwa,
Clearance Officer.
[FR Doc. E9-17509 Filed 7-22-09; 8:45 am]
BILLING CODE 7905-01-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>