State Operations Manual (Pub. 100-07), Ch. 2 § 2814
Change in Control/Ownership or Service Area (42 CFR 486.310)
2814 – Change in Control/Ownership or Service Area (42 CFR 486.310)
(Rev. 111, Issued: 04-11-14, Effective: 04-11-14, Implemetation: 04-11-14)
The applicable CMS RO must be notified before a designated OPO implements a change
in either ownership or control or in its service area. The OPO must provide information to
the CMS RO that is specific to the board structure of the new organization, as well as
operating budgets, financial information, and other written documentation the CMS RO
determines to be necessary for designation. A designated OPO considering a change in its
service area must obtain prior CMS RO approval.
If an OPO’s change of ownership or control is of such an extent that it no longer meets the
requirements for designation as an OPO, as determined on Form CMS-576, CMS may
de-certify the OPO and designate its service area an open area. The OPO may appeal such
a de-certification under §486.314. The service area is not opened for competition until the
conclusion of the administrative appeals process. The OPO must submit a revised Form
CMS-855 (Medicare Enrollment Application) to the FI/MAC with any change of control
or ownership.
* See 2812.3 Open Competition
When the CMS RO receives notification of a prospective change in control or ownership
for a designated OPO, the CMS RO must determine, based upon the documents submitted,
that the operation of the OPO will continue uninterrupted and continue to satisfy Medicare
and Medicaid requirements during and following the changeover of ownership or control.
The CMS RO will review all the documents submitted by the OPO, including its
responses to the elements on Form CMS-576. If the RO approves the CHOW/change of
control and the OPO proceeds with change of ownership a new CMS Form 576 must be
signed by the person designated by the governing body to be responsible for operations.
The OPO should show evidence of transition planning to ensure continuity. Confirm with
the Fiscal Intermediary/MAC that the OPO has submitted a revised CMS Form-855 and
that the information has been accepted.
De-certification (42 CFR 486.312)