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US · guidance

CMS Pub. 100-16, ch. 12, § 30.2

The Novation Agreement Provisions

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

Exhibit 1 contains a Model novation agreement. This agreement is intended to serve only

as a guide in preparing a draft novation agreement. MA organizations may need to revise

the model, as necessary or appropriate, to conform to the circumstances of a particular

transaction involving a change of ownership.

Any novation agreement shall contain the following provisions:

• Assumption of contract obligations. The new owner must assume the transferor’s

entire Medicare book of business and all obligations under the contract.

• Waiver of right to reimbursement. The previous owner must waive its rights to

reimbursement for covered services furnished during the rest of the current

contract period.

• Guarantee of performance. The previous owner must guarantee for the remainder

of the current contract year and, if the bid has already been submitted by the

original owner entity, for the upcoming contract year, that the new owner will

carry out all terms of the contract.

• Records access. The previous owner must agree to make its books and records

and other necessary information available to the new owner and to CMS to permit

an accurate determination of costs for the final settlement of the contract period.

History

(Rev. 113, Issued: 05-17-13, Effective: 05-17-13, Implementation: 05-17-13)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
51f1ae46d24f4c148175546d4843d7e0f2c61a0166395891ead7093e480d6169
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