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Medicaid Providers Reminded to Report Changes in Ownership or Control

In the March 2023 Medicaid Update, the Department of Health (DOH) reminded Medicaid-enrolled providers to file an ownership and control interest disclosure form within 15 days of a change in ownership or control. The disclosure requirement applies to changes in direct or indirect ownership or control as defined in Medicaid regulations. Failure to submit the required disclosure form may result in termination of the provider's enrollment in the Medicaid program.

For purposes of this disclosure requirement, ownership or control means that the person or entity:

  • has an ownership interest totaling 5 percent or more in a disclosing entity;
  • has an indirect ownership interest equal to 5 percent or more in a disclosing entity;
  • has a combination of direct and indirect ownership interests equal to 5 percent or more in a disclosing entity;
  • owns an interest of 5 percent or more in any mortgage, deed of trust, note, or other obligation secured by the disclosing entity if that interest equals at least 5 percent of the value of the property or assets of the disclosing entity;
  • is an officer or director of a disclosing entity that is organized as a corporation; or
  • is a partner in a disclosing entity that is organized as a partnership.

Ownership interest is defined as possession of equity in the capital, stock, or profits of a provider.

Changes of ownership or control interest must be reported to the DOH Office of Health Insurance Programs (OHIP) by filing an amended, signed ownership and control interest disclosure form. Based upon the information supplied, providers may also be required to complete a new NYS Medicaid provider enrollment application to reflect the structural change to their business. Copies of the required disclosure forms can be found here. Providers may contact the eMedNY Call Center at 800-343-9000 for assistance.

More information is found in the Medicaid Update here.

Contact: Karen Lipson, klipson@leadingageny.org