68 FR 182 pgs. 54904-54905 - Agency Information Collection Activities: Proposed Collection; Comment Request
Type: NOTICEVolume: 68Number: 182Pages: 54904 - 54905
Docket number: [Document Identifier: CMS-10028A,B,C]
FR document: [FR Doc. 03-23913 Filed 9-18-03; 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 Identifier: CMS-10028A,B,C]
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.
Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: State Health Insurance Assistance Program (SHIP) Client Contact Form, Public and Media Activity Form, and Resource Report; Form No.: CMS-10028A, B, C (OMB# 0938-0850); Use: The State Health Insurance Assistance Program (SHIP) Client Contract form will be completed by SHIP counselors at each counseling event in order to collection SHIP performance data. This data will then be accumulated and analyzed to measure SHIP performance; Frequency: Semi-annually and annually; Affected Public: State, Local, or Tribal Government, not-for-profit institutions, and Federal Government; Number of Respondents: 53; Total Annual Responses: 265; Total Annual Hours: 159.
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: September 12, 2003.
Julie Brown,
CMS Reports Clearance Officer, Office of Strategic Operations and Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 03-23913 Filed 9-18-03; 8:45 am]
BILLING CODE 4120-03-P