10A NCAC 22N .0202. DISCLOSURE OF OWNERSHIP

Providers licensed under North Carolina G.S. 122C or G.S. 131D shall comply with the following disclosure conditions:

(1)           When applying to participate in the North Carolina Medicaid program, the provider shall supply the legal name and social security number of each individual who is an owner.

(2)           An enrolled provider shall notify the Division of Medical Assistance in writing of a change in the legal name of any owner.  The notification must be received within 30 business days following the change.

(3)           An enrolled provider shall notify the Division of Medical Assistance in writing if a new owner joins the provider.  The notification shall include the new owner's legal name and social security number.  The notification must be received no later than 30 business days following the change.

(4)           An enrolled provider shall notify the Division of Medical Assistance in writing if an owner withdraws his ownership interest in the provider.  The notification shall include the name of the departing owner and must be received no later than 30 business days following the change.

 

History Note:        Authority G.S. 108A-54; 143B-139.1;

Eff. July 1, 2004.