Federal Register: October 2, 2002 (Volume 67, Number 191)
DOCID: FR Doc 02-24976
RAILROAD RETIREMENT BOARD
Railroad Retirement Board
ACTION: Agency information collection activities:
Agency Forms Submitted for OMB Review
In accordance with the Paperwork Reduction Act of 1995 (44
U.S.C. Chapter 35), the Railroad Retirement Board (RRB) has submitted
the following proposal(s) for the collection of information to the Office of Management and Budget for review and approval.
Summary of Proposal(s)
(1) Collection title: Request for review of Part B Medicare Claim. (2) Form(s) submitted: G790, G791.
(3) OMB Number: 32200100.
(4) Expiration date of current OMB clearance: 11/30/2002. (5) Type of request: Extension of a currently approved collection. (6) Respondents: Individuals or Households.
(7) Estimated annual number of respondents: 4,000.
(8) Total annual responses: 4,100.
(9) Total annual reporting hours: 1,025.
(10) Collection description: The Railroad Retirement Board administers the Medicare program for persons covered by the railroad retirement system. The request provides the means for obtaining review by Palmetto GBA on claims for Part B Medicare benefits.
Submission for OMB review; comment request,