[Federal Register: May 7, 2004 (Volume 69, Number 89)]
[Notices]
[Page 25591-25592]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr07my04-68]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-R-268, CMS-10072, and CMS-R-312]
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: Survey Tool for
Medicare.gov website; Form No.: CMS-R-268 (OMB 0938-0756);
Use: CMS has developed a survey tool using MSInteractive to obtain
feedback from users accessing medicare.gov website to guide future
improvements; Frequency: On Occasion; Affected Public: Individuals or
households and business or other for-profit; Number of Respondents:
5,000; Total Annual Responses: 5,000; Total Annual Hours: 417.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Survey Tool for
Medicare.gov website; Form No.: CMS-10072 (OMB 0938-0900);
Use: CMS has developed a survey tool using MSInteractive to obtain
feedback from users accessing cms.hhs.gov website to guide future
improvements; Frequency: On Occasion; Affected Public: Individuals or
households and business or other for-profit; Number of
[[Page 25592]]
Respondents: 5,000; Total Annual Responses: 5,000; Total Annual Hours:
417.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Conflict of
Interest and Ownership and Control Information; Form No.: CMS-R-312
(OMB 0938-0795); Use: This information is required by Public
Law 95-142 as a condition of participation in the Medicare program. The
Fiscal Intermediaries and Carriers are contractually required as a
condition for renewal of their contracts to submit to CMS any ownership
and control interest information; Frequency: Annually; Affected Public:
Not-for-profit institutions and business or other for-profit; Number of
Respondents: 37; Total Annual Responses: 37; Total Annual Hours:
11,100.
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://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 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: Melissa Musotto, Room C5-14-03, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
Dated: April 29, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, Office of Strategic Operations and
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 04-10388 Filed 5-6-04; 8:45 am]
BILLING CODE 4120-03-P