Document Headings

                    Document headings vary by document type but may contain                    the following:                  
                -                       the agency or agencies that issued and signed a document                    
                -                       the number of the CFR title and the number of each part                      the document amends, proposes to amend, or is directly                      related to                    
                -                       the agency docket number / agency internal file number                    
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###### Department of Health and Human Services

###### Centers for Medicare & Medicaid Services

          - [Document Identifier: CMS-1513]

# 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                               ( print 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                     *Paperwork@cms.hhs.gov*, 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