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  • CBIC Site
  • Round 1 2017
  • Round 1 Rebid
  • Round 1 Recompete
  • Round 2 Recompete
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Round 1 Rebid

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Contract Suppliers

These forms are no longer available for the Round 1 Rebid.

Change of Ownership - Purchaser Form
Purchasers of contract suppliers may request the transfer of a contract as part of a change of ownership transaction. A Purchaser should provide all information on this form and the required documentation outlined in the Change of Ownership (CHOW) fact sheet at least 30 calendar days before the effective date of the CHOW.
Contract Supplier Change of Information Form
Please complete and submit the form below if you wish to: Change the authorized official (AO) to another AO on file with the National Supplier Clearinghouse (NSC); Add or remove a backup authorized official (BAO) who is an AO on file with the NSC; Change an e-mail address or phone number for an AO or BAO; Add/update a toll-free number for the Supplier Directory on the Medicare website; or Add/update a doing-business-as name for the Supplier Directory.
Contract Supplier Location Update Form
Contract suppliers may request that locations be added to or removed from their contracts. Additions or removals may be requested at any time. All requests are subject to approval by the Centers for Medicare & Medicaid Services (CMS) and will be processed as quickly as possible after final contract execution.
Form C
Instructions to complete the quarterly report updating product information posted on the Medicare Supplier Directory.
Subcontractor Disclosure Form
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires contract suppliers to disclose to CMS information regarding their subcontracting relationships. This information must be provided within 10 business days after final contract execution. For subcontracting arrangements entered into after contract award, contract suppliers must provide the required information no later than 10 business days after the date the contract supplier enters into a subcontracting arrangement.

last updated on 12/13/2013


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