- Medicare Hospice Quick Reference Sheet
- Hospice Certifying Physician Medicare Enrollment Information
- Hospice Notice of Election Termination/Revocation
- Hospice Room and Board Denials
- Professional Services During a Patient Hospice Election
- Tips to Facilitate the Change of Ownership Process
- Service Intensity Add-on Payment
- Counting 60-Day Election Periods
- Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement
- Hospice Billing Codes Chart
- Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77
- Avoiding Reason Code U5181: Appropriate Use of Occurrence Code 27/Occurrence Span Code 77
- Hospice Notice of Change of Ownership
- Filing an Electronic Notice of Change of Ownership (TOB 8XE)
- Hospice Change of Ownership
- Filing an Electronic Notice of Cancelation (Type of Bill 8XD)
- Filing an Appeal for Claims Rejected for an Untimely Hospice Notice of Election
- Filing an Electronic Notice of Transfer (Type of Bill 8XC)
- Counting 60-Day Election Periods - Leap Year
- Hospice Site of Service Codes
- Billing Hospice Physician, Nurse Practitioner and Physician Assistant Services (Related To Terminal Diagnosis)
- Correcting Hospice Claims Sequentially to Avoid Reason Code U5181
- Common Working File System Edit F5052 and M5052
- Hospice Visit Reporting
- The Medicare Hospice Benefit: Effects on Other Provider Types
- Counting 90-Day Election Periods - Leap Year
- Reporting Hospice Discharges, Revocations and Transfers
- Filing an Electronic Notice of Termination-Revocation of Election (Type of Bill 8XB)
- Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims
- Notice of Election: Timely Filing of Hospice Elections
- Hospice Claim Submission Job Aid
- Direct Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, VBID Model, Participating MAOs
- Counting 90-Day Election Periods
- Hospice Quality Reporting Program
- Filing an Electronic Notice of Election (Type of Bill 8XA)
- Hospice Prescription Drug and Infusion Pump Reporting
- Hospice Caps Job Aid
- Value-Based Insurance Design Model Hospice Benefit Component Overview
- Documentation for Hospice Transfers
- Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines
- Appropriate Use of Condition Code 85
- How to Correct/Avoid Reason Code U5150
- General Inpatient Check Off List
- Hospice Transfers Job Aid
- Medicare Two Tier Routine Home Care Payment Rate
- Canceling a Hospice Notice of Election
- Hospice Pricer Tool Quick Reference Tool
- How to Bill When the Hospice Face-to-Face is Late from a Previous Benefit Period
- Site of Service Codes for Continuous Home Care and General Inpatient Care Level of Service
- Hospice Payment Rates
- Billing Medicare for a Denial - Condition Code 21
- Reminder on Deleting Revenue Code Line(s) in the Fiscal Intermediary Standard System Direct Data Entry System
Tips to Facilitate the Change of Ownership Process
A CHOW typically occurs when a Medicare provider has been purchased (or leased) by another organization. The CHOW results in the transfer of the previous owner’s Medicare Identification Number and provider agreement (including the previous owner’s outstanding Medicare debts) to the new owner. The regulatory citation for CHOWs is in the 42 Code of Federal Regulations (CFR).
Table of Contents
- CHOW Reminders
- Seller/Former Owner
- Buyer/New Owner: Requirements
- EFT Payments and CHOWs
- Additional Documentation Requirements
- Related Content
CHOW Reminders
- As referenced in 42 CFR. 424.520(b), changes of ownership or control must be reported within 30 days of the effective date of the change.
- The transfer of corporate stock or the merger of another corporation into the provider corporation does not constitute a CHOW.
- In the case of an acquisition/merger, the seller/former owner’s Medicare Identification Number dissolves.
- In a CHOW, the seller/former owner’s provider number typically remains intact and is transferred to the new owner.
- If the Tax Identification Number (TIN) changes, it is typically submitted as a CHOW
- A CHOW generally occurs when the assets of the company are sold
- The purchaser must be willing to accept terms and conditions of the provider agreement
- Purchaser must accept responsibility for all liabilities of the current owner
Seller/Former Owner
- Seller/former owner must complete and submit the following sections of the CMS 855A form: 1A, 2F, 13, and 15 or 16
- Seller/former owner CMS-855A CHOW application does not require a recommendation for approval or denial; any recommendations will be based upon the CHOW application received from the new owner.
Buyer/New Owner: Requirements
- Complete and submit all sections of the CMS 855A form, except 2G and 2H.
- Obtain National Provider Identifier (NPI) before enrolling.
- Submit the authorization agreement for electronic funds transfer (EFT), form CMS-588 (Electronic Funds Transfer Agreement)
EFT Payments and CHOWs
- National Government Services will continue to pay the seller/former owner until we receive the tie-in notice from CMS.
- After CHOW processing is complete based on CMS approval, the seller/transferor will no longer be allowed to bill for services.
- National Government Services will no longer have the ability to update the NPI crosswalk in order for the seller to complete their billing.
- It is ultimately the responsibility of the seller/former owner and buyer/new owner to work out any payment arrangements between themselves for claims for services furnished during the CHOW process period.
Additional Documentation Requirements
- Submit a copy of the bill of sale or purchase agreement.
- Submit all appropriate licenses and certifications required by their state.
- Submit IRS document confirming TIN.
- Submit Articles of Incorporation.
Related Content
- CMS-855A Medicare Enrollment Application
- CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 10 – Medicare Provider/Supplier Enrollment
- MLN Matters® Article SE17012: Updated Manual Guidelines for Electronic Funds Transfer (EFT) Payments and Change of Ownership (CHOW)
- Provider Enrollment Status Inquiry Tool – A new process for checking the status of your provider enrollment application.