Last updated on Jul 2, 2026
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What is Ownership Control Disclosure
The Disclosure of Ownership and Control Interest Statement (CMS-1513) is a government form used by healthcare providers to disclose ownership and control interests.
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Ownership Control Disclosure is needed by:
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Healthcare providers participating in Medicare or Medicaid
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Owners of healthcare facilities
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Authorized representatives responsible for compliance
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Regulatory compliance officers
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Legal advisors in healthcare
Comprehensive Guide to Ownership Control Disclosure
What is the Disclosure of Ownership and Control Interest Statement (CMS-1513)?
The CMS-1513 form is a critical document for healthcare providers, specifically designed to disclose ownership and control interests that may affect their operations. This disclosure is vital, as it ensures transparency within the healthcare system and helps maintain compliance with regulations. Understanding the significance of disclosing ownership and control interests is essential for both providers and patients, making the process integral to maintaining trust in healthcare practices.
Purpose and Benefits of the Disclosure of Ownership and Control Interest Statement
This form is necessary for healthcare providers to ensure compliance with Medicare and Medicaid programs. By completing the CMS-1513, providers can avoid potential legal issues and penalties associated with inaccurate disclosures. Compliance with the form not only demonstrates good faith but also safeguards the provider’s reputation within the healthcare industry.
Benefits of timely and accurate reporting of ownership details include:
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Improved regulatory compliance
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Protection against audits
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Enhanced credibility with stakeholders
Who Needs to Complete the Disclosure of Ownership and Control Interest Statement?
Various entities and organizations are required to submit the CMS-1513 form, particularly those that participate in Medicare and Medicaid programs. This may include hospitals, clinics, and individual practitioners among others. Each organization must designate an authorized representative responsible for completing and signing the form, ensuring that all information provided is accurate and complete.
Key Features of the CMS-1513 Form
The CMS-1513 form contains several sections that collect critical data regarding ownership and control interests. Key features of the form include:
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Identification of the entity’s ownership structure
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Disclosure of management information
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Attestation through required signatures and dates
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Specific fields for inputting entity details
Attention to detail is crucial in these sections to prevent issues during the submission process.
How to Fill Out the Disclosure of Ownership and Control Interest Statement Online (Step-by-Step)
Filling out the CMS-1513 form online using pdfFiller can simplify and expedite the process. To complete the form digitally, follow these steps:
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Gather all necessary information regarding ownership and management.
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Access the CMS-1513 form template on pdfFiller.
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Fill in the required fields accurately, ensuring completion of all sections.
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Review the information for accuracy before submission.
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Sign the form electronically using pdfFiller's eSign feature.
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Submit the form following the provided instructions.
By following these steps, providers can mitigate errors commonly associated with traditional paper forms.
Common Errors and How to Avoid Them When Submitting the CMS-1513 Form
Many errors can occur when completing the CMS-1513 form, potentially leading to rejection by governing bodies. Common mistakes include:
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Incomplete fields or missing signatures
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Providing incorrect entity details
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Failing to check for updates in ownership structure
To avoid these issues, double-check each entry and ensure that all signatures and necessary documentation are included before submission.
Submission Methods for the Disclosure of Ownership and Control Interest Statement
There are several ways to submit the completed CMS-1513 form, ensuring flexibility for healthcare providers. Methods include online submission, mailing a printed copy, or delivering it in person. Important considerations for submission include:
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Checking submission deadlines to avoid penalties
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Obtaining confirmation of submission
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Tracking the status of the submitted form
Each submission method has its own set of guidelines that must be followed to ensure compliance.
Security and Compliance Considerations
Data protection is paramount when handling the CMS-1513 form. Compliance with regulations such as HIPAA and GDPR requires healthcare providers to ensure that sensitive information is managed securely. pdfFiller employs robust security measures, including 256-bit encryption, to protect documents throughout the disclosure process.
After Submission: What Happens Next?
Following the submission of the CMS-1513 form, providers can expect a processing period during which their submission is reviewed. To check the status of the submitted form:
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Follow up with the appropriate regulatory body.
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Monitor for any notifications or requests for additional information.
If issues arise, providers should be prepared to address them promptly to maintain compliance.
Streamline Your Disclosure Process with pdfFiller
Utilizing pdfFiller significantly simplifies the process of completing and submitting the CMS-1513 form. Features such as editing, eSigning, and secure storage make managing healthcare ownership disclosures straightforward and efficient. By leveraging these tools, healthcare providers can enhance their disclosure process and ensure their submissions are accurate and compliant.
How to fill out the Ownership Control Disclosure
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1.Access the Disclosure of Ownership and Control Interest Statement on pdfFiller by navigating to their website and locating the form in the government forms section.
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2.Open the form to view the fillable fields and instructions provided within pdfFiller's interface.
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3.Gather all necessary information, including the ownership details, control interests, and management changes, before beginning the completion of the form.
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4.Begin by filling out the 'Name of Entity D/B/A Provider No.' section accurately with the required entity details.
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5.Proceed to complete the checkboxes for ownership interests and control interests, ensuring each selection accurately reflects your current situation.
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6.Check the instructions provided in the form for specific information on additional sections that may need to be completed based on your disclosure requirements.
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7.After completing all fields, review your entries carefully to ensure accuracy and completeness. Look for any omissions or errors.
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8.Once satisfied with the entries, sign and date the form where indicated. Make sure the authorized representative signs as required.
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9.Finalize the form by reviewing the confirmation dialog in pdfFiller, and save your work to prevent loss of information.
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10.Download a copy of the completed form for your records and, if necessary, submit it electronically or print it for mailing following any additional submission guidelines provided.
Who is eligible to complete the Disclosure of Ownership and Control Interest Statement?
Healthcare providers participating in Medicare or Medicaid must complete this form. It is required to disclose information about ownership interests and control for compliance with government regulations.
Are there deadlines for submitting this form?
Deadlines for submission can vary based on specific circumstances related to ownership changes or regulatory requests. It's crucial to check for any time-sensitive requirements indicated by regulatory bodies.
How should I submit the Disclosure of Ownership and Control Interest Statement?
The form can be submitted electronically through pdfFiller or printed and mailed. Ensure you follow the specific submission guidelines appropriate for the regulatory body involved.
What supporting documents are required with this form?
Typically, no specific supporting documents are required with the form itself. However, it is advisable to keep any relevant ownership documentation on hand in case of inquiries.
What are common mistakes to avoid when filling out this form?
Common mistakes include providing inaccurate or incomplete ownership information, neglecting to sign the form, and failing to review the form for errors before submission.
What is the processing time for this form?
Processing times can vary based on the reviewing authority and the volume of submissions. Generally, it may take several weeks to process once submitted, but be sure to confirm with the correct agency.
Is notarization required for the Disclosure of Ownership and Control Interest Statement?
No, notarization is not required for this form. However, it must be signed by an authorized representative to be considered valid.
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