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Provider Enrollment Information
 
ADAP Change in Ownership
Providers Have 35 Days to Report a 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 & Medicaid Services Final Rule 42 C.F.R. 455.104(c)(l)(iv).

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

Note: For demographic changes that do not constitute a change in ownership, providers should update their current information using the demographic maintenance tool.

Written Notification and a New Enrollment Application Are 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 (National Provider Identifier [NPI] or provider ID), within 35 calendar days after the effective date of the change in ownership.

Providers will receive written notification of their new ADAP enrollment effective date in the mail once their provider file is updated with the change in ownership.

Events That ADAP Considers a Change in Ownership

ADAP defines a change in ownership as an event where a different party purchases (buys out) or otherwise obtains ownership or effective control over a practice or facility.

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 ID number associated with the provider's submitted enrollment application (for example, Employer ID Number).
  • Change (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

ADAP-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, ADAP will hold responsible for repayment the provider to whom a transfer of ownership is made. Prior to final transfer of ownership, the provider acquiring the business is responsible for contacting ADAP to ascertain if they are liable under this provision.

The provider acquiring the business is responsible for full repayment within 30 days after receiving such notice from ADAP.

For Further Questions

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

 
 
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