Use of CCRs in Mergers, Acquisitions, Other Ownership

10.11.4 - Use of CCRs in Mergers, Acquisitions, Other Ownership Changes, or Errors Related to CCRs (Rev. 1657, Issued: 12-31-08, Effective: 01-01-09, Implementation: 01-05-09) The contractors use the CCR for the surviving provider in cases of provider merger, acquisition or other such changes. Effective for hospitals experiencing a change of ownership after January 1, 2007, that have not accepted assignment of an existing hospital's provider agreement in accordance with 42 CFR 489.18, and do not yet have a Medicare cost report, the contractor may use the default Statewide CCR to determine cost-based payments until the hospital has submitted its first Medicare cost report. See §10.11.10 for the location of the Statewide CCRs and the upper limit above which the contractor must use the Statewide CCR. For purposes of identifying a CCR for payment, Medicare contractors may apply a Statewide average to hospitals receiving a new provider number, such as hospitals converting from non-IPPS to IPPS status. Also, for purposes of identifying a CCR for payment, hospitals receiving a new provider number may request use of a different CCR based on substantial evidence. Use of an alternative CCR is subject to the approval of the CMS central and regional offices as discussed in §10.11.3.2. For hospitals experiencing a change of ownership prior to January 1, 2007, the contractor should use the prior hospital's CCR. In instances where errors related to CCRs and/or outlier payments are discovered, the Medicare contractor shall contact the CMS central office to seek further guidance. Medicare contractors may contact the CMS central office via the address and e-mail address listed in §10.11.3.1 of this chapter. If a cost report is reopened after final settlement and as a result of this reopening, there is a change to the CCR, Medicare contractors should contact the CMS regional and central office for further instructions. Medicare contractors may contact the CMS central office via the address and email address listed in §10.11.3.1.