The July 2011 version of the CMS-855A application contains various new data elements in sections 5 and 6.  This message notifies providers that they need not complete the following data elements on either the paper or Internet-Based PECOS versions of the CMS-855A application: 

Section 5  OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (ORGANIZATONS)

• “Exact percentage of operational/managerial control this organization has in the provider”

Section 6   OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS)

• “Exact percentage of control as an Officer this individual has in the provider”
• “Exact percentage of control as a Director this individual has in the provider”
• “Exact percentage of management control this individual has in the provider” (under the “W-2 Managing Employee” heading)
• “Exact percentage of this contracted managing employee’s control in the provider”
• “Exact percentage of operational/managerial control this individual has in the provider”

In addition, under the "Other ownership or control/interest" headings in sections 5 and 6, the “Exact percentage of ownership or control/interest…” data element need not be completed if the organization/individual does not have an ownership, partnership, mortgage, security, or other quantifiable interest in the provider.

The Medicare contractors have already received guidance to this effect.

If you have any questions regarding this message, please contact your local Medicare contractor.  Contact information can be found at http://www.CMS.gov/MedicareProviderSupEnroll/downloads/contact_list.pdf