[Federal Register: November 5, 2004 (Volume 69, Number 214)]
[Notices]
[Page 64575]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05no04-58]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicine and Medicaid Services
[Document Identifier: CMS-R-306 and CMS-R-148]
Agency Information Collection Activities: Proposed Collection;
Comment Request
Agency: Centers for Medicare and Medicaid Services.
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: Restraint and
Seclusion Standards for Psychiatric Residential Treatment Facilities;
Use: Psychiatric residential treatment facilities are required to
report deaths, serious injuries and attempted suicides to State
Medicaid Agency and Protection and Advocacy Organization. They are also
required to provide residents restraint and seclusion policy in
writing, and to document resident record of all activities involving
use of restraint and seclusion. Form Number: CMS-R-306 (OMB:
0938-0833); Frequency: On occasion; Affected Public: Business or other
for-profit and Not-for-profit institutions; Number of Respondents: 500;
Total Annual Responses: 2,600,000; Total Annual Hours: 877,750.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Limitations on
Provider Related Donations and Health Care Related Taxes; Limitation on
payments to Disproportionate Share Hospitals; Medicaid and Supporting
Regulations in 42 CFR 433.68, 433.74, and 447.272.; Use: This
information collection is necessary to ensure compliance with Sections
1903 and 1923 of the Social Security Act for the purpose of preventing
payment of federal financial participation on amounts prohibited by the
statute. Form Number: CMS-R-148 (OMB: 0938-0618); Frequency:
Quarterly; Affected Public: State, Local or Tribal Gov't; Number of
Respondents: 50; Total Annual Responses: 40; Total Annual Hours: 3,200.
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://www.cms.hhs.gov/regulations/pra/, or E-mail
your request, including your address, phone number, OMB number, and CMS
document identifier, to Paperwork@cms.hhs.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: October 28, 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. 04-24781 Filed 11-4-04; 8:45 am]
BILLING CODE 4120-03-M