[Federal Register Volume 70, Number 194 (Friday, October 7, 2005)]
[Notices]
[Pages 58707-58708]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-20101]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1513]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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 function; (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 XVIII, XIX, 
Clinical Laboratory Improvement Amendments (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

[[Page 58708]]

Annual Responses: 125,000; Total Annual Hours: 62,500.
    To obtain copies of the supporting statement and any related forms 
for these 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.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB Desk 
Officer at the address below, no later than 5 p.m. on November 7, 2005.
    OMB Human Resources and Housing Branch, Attention: CMS Desk 
Officer, New Executive Office Building, Room 10235, Washington, DC 
20503.

    Dated: September 29, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-20101 Filed 10-6-05; 8:45 am]
BILLING CODE 4120-01-P