[Federal Register: September 28, 2007 (Volume 72, Number 188)]
[Notices]               
[Page 55218-55219]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr28se07-97]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-312]

 
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: Conflict of 
Interest and Ownership and Control Information; Use: The Conflict of 
Interest and Ownership and Control Information Statement (COI 
Statement) is sent to all Medicare Fiscal Intermediaries (FIs) and 
Carriers to collect full and complete information on any entity's or 
individual's ownership interest (defined as a 5 per centum or more) in 
an organization that may present a potential conflict of interest in 
their role as a Medicare FI or Carrier.
    The information gathered in the survey is used to ensure that all 
potential, apparent and actual conflicts of interest involving Medicare 
contractors are appropriately mitigated and that employees of the 
contractors, including officers, directors, trustees and members of 
their immediate families, do not utilize their positions with the 
contractor for their own private business interest to the detriment of 
the Medicare program. Information is also requested on potential 
organizational

[[Page 55219]]

conflicts of interest involving Medicare contractors' ownership of 
other entities in the health care industry. If a response has indicated 
that a potential conflict of interest exists, the contractor is 
contacted and asked to address how the conflict can be avoided or 
mitigated. Form Number: CMS-R-312 (OMB: 0938-0795); Frequency: 
Reporting--Annually; Affected Public: Private Sector--Business or other 
for-profit and Not-for-profit institutions; Number of Respondents: 37; 
Total Annual Responses: 37; Total Annual Hours: 11,100.
    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/PaperworkReductionActof1995, 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.
    Written comments and recommendations for the proposed information 
collections must be mailed or faxed within 30 days of this notice 
directly to the OMB desk officer: OMB Human Resources and Housing 
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 
10235, Washington, DC 20503, Fax Number: (202) 395-6974.

    Dated: September 21, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E7-19247 Filed 9-27-07; 8:45 am]

BILLING CODE 4120-01-P