Change of Management Company
CMS 855A Sections Required
Section 1 (A.1,A.2,A.3)
Section 5
Section 6 (for authorized representative, if no application is on file.)
Section 15
Please note if ownership or the level of control is changing, the entire application may be required.
Stock Transfers do not warrant a change of ownership, but do require a change of information application. All sections impacted by the Stock Transfer must be completed. Please refer to the Stock Transfer information provided for additional information.
Supporting Documentation
A copy of the management agreement may be requested.
Actions Taken by Intermediary
Providers will receive a confirmation letter notifying them that the management company has been changed.