[Federal Register: September 12, 2003 (Volume 68, Number 177)]
[Notices]
[Page 53742]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12se03-59]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[CMS-1515/1572]
Agency Information Collection Activities: Submission for OMB
Review; 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.
Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Home Health
Agency Survey and Deficiencies Report, Home Health Functional
Assessment Instrument and Supporting Regulations in 42 CFR 488.26 and
442.30; Form No.: CMS-1515/1572 (OMB 0938-0355); Use: In order
to participate in the Medicare program as a Home Health Agency (HHA)
provider, the HHA must meet Federal Standards. These forms are used to
record information about patients' health and provider compliance with
requirements; Frequency: Annually; Affected Public: Business or other
for-profit, Not-for-profit institutions, Individuals or households;
Number of Respondents: 24,150; Total Annual Responses: 24,150; Total
Annual Hours: 3,864.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
Site address at http://cms.hhs.gov/regulations/pra/default.asp, 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 30 days of this notice directly to the OMB desk officer:
OMB Human Resources and Housing Branch, Attention: Brenda Aguilar, New
Executive Office Building, Room 10235, Washington, DC 20503.
Dated: September 5, 2003.
Julie Brown,
CMS Reports Clearance Officer, Office of Strategic Operations and
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 03-23214 Filed 9-11-03; 8:45 am]
BILLING CODE 4120-03-P