67 FR 193 pgs. 62248-62249 - Agency Information Collection Activities: Proposed Collection; Comment Request
Type: NOTICEVolume: 67Number: 193Pages: 62248 - 62249
Docket number: [Document Identifiers: CMS-377/378/R-54, CMS-359/360/R-55]
FR document: [FR Doc. 02-25218 Filed 10-3-02; 8:45 am]
Agency: Health and Human Services Department
Sub Agency: Centers for Medicare and Medicaid Services
Official PDF Version: PDF Version
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifiers: CMS-377/378/R-54, CMS-359/360/R-55]
Agency Information Collection Activities: Proposed Collection; Comment Request
AGENCY:
Centers for Medicare and Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid Services (CMS) (formerly known as 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: Extension of a currently approved collection; Title of Information Collection: Request for Certification, CMS-377 and the Ambulatory Surgical Center Survey Report Form, CMS-378 and CMS-R-0054 Supporting Regulations Contained in 42 CFR 416.1 thru 416.49; Form No.: CMS-0377/0378/R-0054 (OMB# 0938-0200); Use: The ASC request for certification form is utilized as an application for facilities wishing to participate in the Medicare program as an ASC. This form initiates the process of obtaining a decision as to whether the conditions of coverage are met. It also promotes data retrieval from the Online Data Input Edit (ODIE system, a subsystem of the Online Survey Certification and Report (OSCAR) system by CMS Regional Offices (RO)). The ASC report form is an instrument used by the State survey agency to record data collection in order to determine supplier compliance with individual conditions of coverage and to report it to the Federal government. The form is primarily a coding worksheet designed to facilitate data reduction and retrieval into the ODIE/OSCAR system at the CMS ROs. This form includes basic information on compliance ( i.e. , met, not met and explanatory statements) and does not require any descriptive information regarding the survey activity itself; Frequency: Annually; Affected Public: State, Local, or Tribal Government; Number of Respondents: 2,798; Total Annual Responses: 2,798; Total Annual Hours: 2,100.
(2.) Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64, 485.66, 410.105; Form No.: CMS-0359/0360/R-0055 (OMB# 0938-0267); Use: In order to participate in the Medicare program as a CORF, providers must meet federal conditions of participation. The certification form is needed to determine if providers meet at least preliminary requirements. The survey form is used to record provider compliance with the individual conditions and report findings to CMS; Frequency: Annually; Affected Public: State, Local, or Tribal Government; Number of Respondents: 556; Total Annual Responses: 556; Total Annual Hours: 264,877.
To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access CMS'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 CMS 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 CMS Paperwork Clearance Officer designated at the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development and Issuances, Attention: Dawn Willinghan,Room N2-14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: September 26, 2002.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, Office of Strategic Operations and Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 02-25218 Filed 10-3-02; 8:45 am]
BILLING CODE 4120-03-P