Form Cms-855a - Medicare Enrollment Application - Institutional Providers Page 6

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SECTION 1: BASIC INFORMATION
(Continued)
Acquisition/Merger
An acquisition/merger occurs when a currently enrolled Medicare provider is purchasing or has been
purchased by another enrolled provider. Only the purchaser’s Medicare Identification Number and tax
identification number remain.
Acquisitions/mergers are different from CHOWs. 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.
Consolidation
A consolidation occurs when two or more enrolled Medicare providers consolidate to form a new
business entity.
Consolidations are different from acquisitions/mergers. In an acquisition/merger, two entities combine but
the Medicare Identification Number and tax identification number (TIN) of the purchasing entity remain
intact. In a consolidation, the TINs and Medicare Identification Numbers of the consolidating entities
dissolve and a new TIN and Medicare Identification Number are assigned to the new, consolidated entity.
Because of the various situations in which a CHOW, acquisition/merger, or consolidation can
occur, it is recommended that the provider contact its fee-for-service contractor or its CMS
Regional Office if it is unsure as to whether such a transaction has occurred. The provider
should also review the applicable federal regulation at 42 C.F.R. 489.18 for additional guidance.
Change of Information
A change of information should be submitted if you are changing, adding, or deleting information under
your current tax identification number. Changes in your existing enrollment data must be reported to the
Medicare fee-for-service contractor in accordance with 42 C.F.R. 424.516(e).
Ownership changes that do not qualify as CHOWs, acquisitions/mergers, or consolidations
NOTE:
should be reported here. The most common example involves stock transfers. For instance, assume that
a business entity’s stock is owned by A, B, and C. A sells his stock to D. While this is an ownership
change, it is generally not a formal CHOW under 42 C.F.R. 489.18. Thus, the ownership change from A
to D should be reported as a change of information, not a CHOW. If you have any questions on whether
an ownership change should be reported as a CHOW or a change of information, contact your fee-for-
service contractor or CMS Regional Office.
If you are already enrolled in Medicare and are not receiving Medicare payments via EFT, any change to
your enrollment information will require you to submit a CMS-588 application. All future payments will
then be made via EFT.
Revalidation
CMS may require you to submit or update your enrollment information. The fee-for-service contractor will
notify you when it is time for you to revalidate your enrollment information. Do not submit a revalidation
application until you have been contacted by the fee-for-service contractor.
CMS-855A (07/11)
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