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CMS Pub. 100-08, ch. 10, § 10.3.2.5

CMS-20134 (Sections 5 & 6 - Owning and Managing

activein force · 2026-08-25 – presentas-observed

Organizations and Individuals)

(Rev. 11891; Issued: 03-09-23; Effective: 04-21-23; Implementation: 06-19-23)

Sections 5 and 6 of the Form CMS-20134 collect data regarding the MDPP supplier’s

organizational and individual owners and managing parties. For detailed information

regarding the completion of these sections and the validation of the data thereon, see

section 10.6.7 of this chapter.

Except as otherwise stated, the PECOS policies in section 10.3 supersede those in section 10.6.7

et seq. (e.g., communicating with the provider via the PCV).

History

(Rev. 11891; Issued: 03-09-23; Effective: 04-21-23; Implementation: 06-19-23)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
eb9c5abae0d66b1e1a633cd7899738f382266c2c9aece54ba369a6d342180982
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CMS Pub. 100-08, ch. 10, § 10.3.2.5 — CMS-20134 (Sect… · binding.law