Sometimes, but not always, this will be indicated by whether there has been a change in the taxpayer identification number.
CHOWs impact the Medicare provider agreement involved in the sale.
These restrictions were put in place because CMS had concerns about the “flipping” of HHAs.
For instance, indirect changes or changes made at the parent level, if properly executed, will not trigger the 36 month rule at the HHA level.
These rules are very technical, so the proposed transfer must be studied carefully prior to the transaction, to ensure that the intended result under the Medicare regulations is obtained.
However, four helpful exceptions to this rule apply when: Moreover, CMS has indicated that indirect changes in majority ownership do not trigger the 36-month rule.
Because of these exceptions and the fact that the rule does not apply to indirect changes in majority ownership, planning opportunities exist so that a CHOW may not be triggered.
The utility of this equation is that it lets you chart acceptable age discrepancies that adjust over the years. Let's examine it: How well does the rule reflect scientific evidence for age preferences?
According to the rule, for example, a 30-year-old should be with a partner who is at least 22, while a 50-year-old’s dating partner must be at least 32 to not attract (presumed) social sanction. Does it match our scientific understanding of age-related preferences for dating? Researchers Buunk and colleagues (2000) asked men and women to identify the ages they would consider when evaluating someone for relationships of different levels of involvement.Unless the buyer takes steps to affirmatively reject the seller's provider agreement, in a Medicare CHOW, the seller's provider agreement is automatically assigned to the buyer.This provides billing advantages for the buyer without having to enroll as a new Medicare provider, go through the initial enrollment process, and be re-surveyed or re-accredited, which takes several months. In contrast, stock purchases, corporate membership transfers, and other transactions where providers will operate under the same taxpayer identification number pre- and post-transaction are typically not considered CHOWs, but simply Medicare “changes of information." CMS imposes additional restrictions on the transfer of a home health agency (“HHA”).You can see that men are basically operating by the rule for minimum age preferences for marital relationships (blue bars) and serious dating relationships (yellow bars).Those age preferences consistently hover around the values denoted by the rule (the black line).Instead, the prospective owner of the home health agency must enroll in the Medicare program as a new HHA and obtain a state survey or accreditation from an approved accreditation organization.