Medicare Managed Care Manual (Pub. 100-16), Ch. 12 § 10.2
Examples of Ownership Transactions
10.2 - Examples of Ownership Transactions
(Rev.113, Issued: 05-17-13, Effective: 05-17-13, Implementation: 05-17-13)
In the following situation, the ownership transaction does not ordinarily result in a change
of ownership:
• If Corporation X maintains a contract with CMS and subsequently purchases the
stock of Corporation Y, the ownership of Corporation X has not ordinarily
changed.
In the following situations, the ownership transaction ordinarily results in a change of
ownership as defined in §10.1 above.
• If Corporation A, Corporation B, and Corporation C, all subsidiaries of
Corporation P (a holding company), consolidate into Corporation ABC (a new
legal entity), and Corporation A, B, and C are fully dissolved, this constitutes a
change in ownership in all Corporations A, B, and C.
• If Corporation A sells or transfers portions of its operations, including operations
related to its MA contract to Corporation B, then:
o If Corporation B has already been deemed an eligible MA entity by CMS,
then this constitutes a change in ownership of the MA contract to Corporation
B.
o If Corporation B is not already deemed an eligible MA organization, it must
submit an application for eligibility to CMS as provided in Chapter 11,
"Application Procedures and Contract Requirements,” of this manual.
• If Corporation A, a Medicare Advantage Organization, merges with its parent,
Corporation B, an eligible MA organization, and Corporation A does not survive
the merger, this constitutes a change in ownership for Corporation A.
The following example illustrates how the same transaction may have different effects of
change of ownership on different corporations.
• If Corporation X maintains a contract with CMS and subsequently acquires
Corporation Z, resulting in a merger then:
o If Corporation X survives, the ownership of Corporation X has not changed.
o If Corporation Z survives, this constitutes a change in ownership of
Corporation X.