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Agency Information Collection Activities: Proposed Collection; Comment Request

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Information about this document as published in the Federal Register.

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Health Care Financing Administration.

In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, 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: Revision of a currently approved collection;

Title of Information Collection: Durable Medical Equipment Regional Carrier, Certificate of Medical Necessity and Supporting Regulations in 42 CFR, Section 407.18 and 410.1;

Form No.: HCFA-841-853 (OMB# 0938-0679);

Use: A Certificate of Medical Necessity is a standardized format used to communicate information provided by an attending physician and a supplier of medical equipment and supplies. The information is used by carriers to determine the medical necessity of an item or service covered by the Medicare program and being used for the treatment of the Medicare beneficiary's condition. The CMNs being submitted for OMB review are necessary in order for HCFA to Start Printed Page 4438determine the medical necessity of the item or service. The information needed to make this determination requires application of medical judgement that can only be provided by a physician or other clinician who is familiar with the condition of the beneficiary;

Frequency: On occasion;

Affected Public: Business or other for-profit, and Federal Government;

Number of Respondents: 140,000;

Total Annual Responses: 6.8 million;

Total Annual Hours: 1.13 to 1.7 million.

To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access HCFA's Web Site address at​regs/​prdact95.htm, or E-mail your request, including your address, phone number, OMB number, and HCFA document identifier, to, 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 HCFA Paperwork Clearance Officer designated at the following address:

HCFA, Office of Information Services, Security and Standards Group, Division of HCFA Enterprise Standards Attention: Dawn Willinghan, Room N2-14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

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Dated: January 16, 2000

John Parmigiani,


HCFA Office of Information Services Security and Standards Group, Division of HCFA Enterprise Standards.

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[FR Doc. 00-1978 Filed 1-26-00; 8:45 am]