CMS Pub. 100-08, ch. 10, § 10.3.1.1.6

If the provider is part of a chain organization, it must complete the Chain Home Office

Information section of the Form CMS-855A with information about the chain home office.

Under 42 CFR § 421.404, a “home office” is the entity that provides centralized management

and administrative services to the providers or suppliers under common ownership and common

control, such as centralized accounting, purchasing, personnel services, management direction

and control, and other similar services. Other definitions relevant to chain organizations (and

which are in § 421.404) include:

• Chain provider - A group of two or more providers under common ownership or control.

• Common control - Exists when an individual, a group of individuals, or an organization has

the power, directly or indirectly, to significantly influence or direct the actions or policies of the

group of suppliers or eligible providers.

• Common ownership – Exists when an individual, a group of individuals, or an organization

possesses significant equity in the group of suppliers or eligible providers.

The contractor shall not delay its processing of the provider’s application while awaiting the

issuance of a chain home office number (i.e., a determination as to whether a set of entities

qualifies as a chain organization). Such an issuance/determination is not required for a

recommendation for approval.

If all of the Chain Home Office Information section is blank (including the check box in this

section), no additional development is necessary. If the provider indicates that it is part of a

chain but the checkboxes in the Chain Home Office Information section are blank, the contractor

can verify the type of transaction involved via the PCV, e-mail, or fax.

If a chain organization listed in Section 7 also serves as the provider’s billing agent, the chain

must also be reported in the Billing Agency section of the Form CMS-855A.

The chain home office administrator (CHOA) must be listed as an owning and/or managing

individual in Section 6 and all final adverse action data must be disclosed. (For purposes of

provider enrollment, a CHOA is deemed to have managing control over the provider.) If the

CHOA reported in Section 7 is listed with complete information in Section 6 (e.g., the

individual’s Social Security Number (SSN) is disclosed in Section 6), only the individual’s first

and last name need be listed in Section 7.

A chain home office must be listed as an owning and/or managing organization in Section 5 and

all final adverse action data must be disclosed. (For purposes of provider enrollment, a chain

home office automatically qualifies as an owning/managing organization.) If the entity is

reported with complete information in Section 5, its legal business name is the only data element

that must be reported in Section 7. (If blank, the contractor may develop for the cost report date,

the home office’s contractor, and the chain number by telephone, e-mail, the PCV, or fax.)

Note that an NPI is typically not required for a chain home office.

If blank, the following data elements can be collected by telephone, e-mail, the PCV, or fax: (i)

Type of Action this Provider is Reporting; (ii) Type of Business Structure of the Chain Home

Office; and (iii) the Provider’s Affiliation to the Chain Home Office).

For more information on chain organizations, refer to:

• Pub. 100-04, chapter 1, sections 20.3 through 20.3.6

• 42 CFR § 421.404

• CMS change request 5720