[Federal Register Volume 70, Number 140 (Friday, July 22, 2005)]
[Notices]
[Page 42325]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-14156]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1513]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & 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 & Medicaid 
Services (CMS) 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: Disclosure of 
Ownership and Financial Control Interest Statement; Form No.: CMS-1513 
(OMB  0938-0086); Use: This information must be collected by 
State agencies and CMS regional offices to determine whether providers/
suppliers meet the eligibility requirements for Titles 18, 19, CLIA, 
and for grants under Titles V and XX. Review of ownership and control 
is particularly necessary to prohibit ownership and control for 
individuals excluded under Federal fraud statutes; Frequency: 
Recordkeeping and Reporting--Other (every 1 to 3 years); Affected 
Public: Business or other for-profit, not-for-profit institutions; 
Number of Respondents: 125,000; Total Annual Responses: 125,000; Total 
Annual Hours: 62,500.
    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 [email protected], 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 to the address 
below: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Melissa Musotto, Room 
C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: July 8, 2005.
Carlos Simon,
Acting Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 05-14156 Filed 7-21-05; 8:45 am]
BILLING CODE 4120-01-P