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Provider Enrollment Information
 
ADAP Change in Ownership

Providers enrolled in the Wisconsin AIDS Drug Assistance Program (ADAP) are required to notify ADAP of a change in ownership within 35 calendar days after the effective date of the change, in accordance with the Centers for Medicare and Medicaid Services Final Rule 42 CFR 455.104(c)(l)(iv). The Wisconsin AIDS Drug Assistance Program defines a change in ownership as follows: when a different party purchases (buys out) or otherwise obtains ownership or effective control over a practice or facility.

Failure to report a change in ownership within 35 calendar days may result in denial of payment, per 42 CFR 455.104(d).

Written Notification and New Enrollment Application Required

Any time a change in ownership occurs, providers are required to do one of the following:

ADAP must receive the change in ownership notification, which must include the affected provider number (i.e., National Provider Identifier [NPI] or provider ID), within 35 calendar days after the effective date of the change in ownership. Once their provider file is updated with the change in ownership, providers will receive written notification of their new ADAP enrollment effective date in the mail

Providers with questions about changes in ownership may call Provider Services.

Events That Are Considered a Change in Ownership

The following events are considered a change in ownership and require the completion of a new provider enrollment application:

  • Change from one type of business structure to another type of business structure. Business structures include the following:
    • Sole proprietorships.
    • Corporations.
    • Partnerships.
    • Limited Liability Companies.
  • Change of name and tax identification number associated with the provider's submitted enrollment application (e.g., Employer Identification Number).
  • Change (i.e., addition or removal) of names identified as owners of the provider.
Examples of a Change in Ownership

Examples of a change in ownership include the following:

  • A sole proprietorship transfers title and property to another party.
  • Two or more corporate clinics or centers consolidate and a new corporate entity is created.
  • There is an addition, removal, or substitution of a partner in a partnership.
  • An incorporated entity merges with another incorporated entity.
  • An unincorporated entity (sole proprietorship or partnership) becomes incorporated.
Repayment Following a Change in Ownership

The Wisconsin AIDS Drug Assistance Program-enrolled providers who sell or otherwise transfer their business or business assets are required to repay ADAP for any erroneous payments or overpayments made to them. If necessary, the provider to whom a transfer of ownership is made will also be held liable by ADAP for repayment. Therefore, prior to final transfer of ownership, the provider acquiring the business is responsible for contacting ADAP to ascertain if he or she is liable under this provision.

The provider acquiring the business is responsible for making payments within 30 days after receiving notice from ADAP that the amount shall be repaid in full.

 
 
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