Ga. Medicaid Part II Policies & Procedures for Hospice Services § 602

602.1. Any enrolled provider that undergoes a change including, but not limited to,

dissolution, incorporation, re-incorporation, reorganization, change of ownership of

assets, merger or joint venture so that as a result, the provider either becomes a different

legal entity or is replaced in the program by another provider, must give the Division

ten (10) days prior written notice before effecting a change.

602.2. The new owner of an already existing agency must complete and submit the Provider

Enrollment Application packet. Failure of the successor to execute a new enrollment

agreement will prevent the Division from reimbursing the new owner for any future

services as of the date of change.

602.3. The same Medicaid Provider Number of the previous hospice agency will transfer to

the new hospice agency.

602.4. Change of ownership does not require election, discharge, revocation, or transfer forms

to be held by the new owners. During the change of ownership of an existing agency

the new owner should continue faxing/sending forms to Gainwell Technologies

Enterprise Services.

602.5. It is up to the new owner if they choose to submit claims prior to the change of their

payee information. Reimbursement will go to the “payee of record”.

602.6. All Hospice Policies and Procedures should continue and be seamless and continuity of

care not interrupted.

602.7. Please refer to Part I Policies and Procedures for Medicaid/PeachCare for Kids for

additional information regarding Provider Enrollment.

602.8. A change in ownership of a hospice agency is not considered a change in the

individual’s designation of hospice and requires no action on the member’s part.