RO Role in CHOW Determination

3210.2 - RO Role in CHOW Determination (Rev. 1, 05-21-04) The RO reviews the SA’s recommendation and, if it concurs that a CHOW has taken place, it annotates the certification file to reflect the change and: • For providers and suppliers that require agreements, the RO issues a notice letter to the provider/supplier that recognizes the CHOW date. The RO sends copies of the letter to the SA, the SMA, the OCR-RO, and the FI(s). It is not necessary to acknowledge CHOWs that have taken place at the remaining supplier types; • For providers and suppliers that require agreements, the RO signs the two original agreement forms previously signed by an authorized representative of the new owning entity and forwarded to the RO by the SA. The RO retains one original agreement form in its certification file and encloses the other with the notice letter to the provider/supplier; • For providers and ESRD facilities, the RO prepares a Provider Tie-In Notice (Form CMS-2007) and forwards it to the FI. If there is a change in FI, the RO sends copies of Form CMS-2007 to the old and the new intermediaries. (See §3210.4); • For all CHOWs, the RO should ensure that a kit of certification documents reflecting the change and all available current information is entered in the OSCAR/ASPEN system. • As corporate structures have become increasingly complex, it has become more difficult for professionals in nonlegal entities to discern all of the management and control relationships in individual situations and to determine accurately whether or not a CHOW has occurred for purposes of the Medicare program. The RO should refer all CHOW determinations that are in any way complicated by the intricacies of the case or otherwise require professional legal expertise to the appropriate Regional Attorney.