THIS COLLECTION
IS APPROVED FOR USE THRU JULY 1983. FINAL REGULATIONS IMPLEMENTING
PROSPECTIVE REIMBURSEMENT FOR RURAL HEALTH CLINICS SHOULD BE
PUBLISHED PRIOR TO THAT TIME. SINCE HCFA REPORTING REQUIREMENTS
SHOULD BE SIGNIFICANTLY REDUCED UNDER THE PROSPECTIVE REIMBURSEMENT
SYSTEM, THIS COLLECTION WILL REQUIRE SUBSTANTIAL REVISION IF IT IS
TO BE USED IN THE FUTURE.
Inventory as of this Action
Requested
Previously Approved
07/31/1983
07/31/1983
1,003
0
0
5,652
0
0
0
0
0
FORM HCFA-222 IS REVISED TO INCLUDE
REIMBURSEMENT FOR PNEUMOCOCCAL VACCINE AND ITS ADMINISTRATION. THIS
FORM IS ALSO REVISED TO ACCOMMODA CHANGES REQUESTED BY THE
SECRETARY AS A RESULT OF AN AUDIT OF RHCS BY GAO. IT WILL BE
COMPLETED BY INDEPENDENT RURAL HEALTH CLINICS AS WELL AS SOME URBAN
CLINICS PARTICIPATING IN A HCFA DEMONSTRATION PROJECT.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.