For example, when the supplier/supplier needs to be consulted by a public authority, human resources may require a long waiting time to complete and report on the investigation. An old “accepted” accreditation status from the seller will not pass to the buyer in the event of a refusal of a Medicare agreement. Even if the supplier/supplier is interviewed by an accreditation body, an investigation conducted quickly after the deadline for submission may be problematic. In the Policy Memorandum, CMS notes that valid surveys are supposed to be unannounced and CMS questioned compliance with this requirement and found that an investigation conducted in time for the deadline for receipt appears to be coordinated or planned. Purchasers of Medicare providers and providers may opt out of automatic allocation and request a new Medicare provider/provider agreement. However, avoiding estate liability has a cost. With each acquisition, certain facts and circumstances determine whether or not a buyer is willing to accept the assignment of a Medicare agreement. A comprehensive review of the seller`s Medicare activities should be conducted and the risks and benefits of uninterrupted cash flow and assumption of Medicare`s liability should be assessed. In addition, a buyer must assess the impact of the many other consequences described above in order to decide whether to refuse the seller`s Medicare provider agreement or allow automatic assignment. Once a business decision has been made, the implementation process can be challenging and it is important to carefully navigate CMS`s rules and regulations and survey procedures. Nixon Peabody has experience in taking care of clients in both automatic assignments and opting out of Medicare agreements and can advise buyers and sellers accordingly.