ownershipandcontrolintereststatement.docVIP

Purpose and Instructions for Completing Provider Ownership and Control Interest Statement Purpose The primary use of the Disclosure of Ownership and Controlling Interest Statement is to comply with screening requirements related to the Patient Protection and Affordable Care Act,/fdsys/pkg/FR-2011-02-02/pdf/2011-1686.pdf and 42 CFR 455.104; to facilitate monitoring of providers sanctioned by the U.S. Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS), DHHS Office of Inspector General, and/or the Oregon Department of Human Services (DHS).