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6.1.C. - Page 58 <br />Supplier means an individual, agency, or organization from which a provider purchases goods and <br />services used in carrying out its responsibilities under Medicaid (e.g., a commercial laundry, a <br />manufacturer of hospital beds, or a pharmaceutical firm). <br />Termination means— <br />(1) For a— <br />(i) Medicaid or CHIP provider, a State Medicaid program or CHIP has taken an action to revoke the <br />provider's billing privileges, and the provider has exhausted all applicable appeal rights or the timeline for <br />appeal has expired; and <br />(ii) Medicare provider, supplier or eligible professional, the Medicare program has revoked the <br />provider or supplier's billing privileges, and the provider has exhausted all applicable appeal rights or the <br />timeline for appeal has expired. <br />(2)(i) In all three programs, there is no expectation on the part of the provider or supplier or the State <br />or Medicare program that the revocation is temporary. <br />(ii) The provider, supplier, or eligible professional will be required to reenroll with the applicable <br />program if they wish billing privileges to be reinstated. <br />(3) The requirement for termination applies in cases where providers, suppliers, or eligible <br />professionals were terminated or had their billing privileges revoked for cause which may include, but is <br />not limited to— <br />(i) Fraud; <br />(ii) Integrity; or <br />(iii) Quality. <br />Wholly owned supplier means a supplier whose total ownership interest is held by a provider or by a <br />person, persons, or other entity with an ownership or control interest in a provider. <br />[44 FR 41644, July 17, 1979, as amended at 51 FR 34788, Sept. 30, 1986; 76 FR 5967, Feb. 2, 2011] <br />t Back to Top <br />§455.102 Determination of ownership or control percentages. <br />(a) Indirect ownership interest. The amount of indirect ownership interest is determined by <br />multiplying the percentages of ownership in each entity. For example, if A owns 10 percent of the stock in <br />a corporation which owns 80 percent of the stock of the disclosing entity, A's interest equates to an 8 <br />percent indirect ownership interest in the disclosing entity and must be reported. Conversely, if B owns 80 <br />percent of the stock of a corporation which owns 5 percent of the stock of the disclosing entity, B's <br />interest equates to a 4 percent indirect ownership interest in the disclosing entity and need not be <br />reported. <br />(b) Person with an ownership or control interest. In order to determine percentage of ownership, <br />mortgage, deed of trust, note, or other obligation, the percentage of interest owned in the obligation is <br />multiplied by the percentage of the disclosing entity's assets used to secure the obligation. For example, if <br />REV: 01-17-18 RL <br />ATTY/AGR/2018.012/COUNTY OF SAN MATEO <br />