Notice of Material Change Transaction

• Before submitting a Material Change Transaction Notice, both of the following must be true:

  1. You are a health care entity. (expand/collapse details)
     “Health care entity” shall:

     1. Have the meaning set forth in section 127500.2(k) of the Code;
     2. Include pharmacy benefit managers as described in sections 127501(c)(12) and 127507(a);
     3. Include parents, affiliates, or subsidiaries that act on behalf of a payer and:
        1. control, govern, or are financially responsible for the entity, or
        2. in the case of a subsidiary, act on behalf of another subsidiary.
     4. Exclude physician organizations with fewer than 25 physicians unless determined to be a high-cost outlier.
  2. You are a party to, or subject of, a transaction. (expand/collapse details)
     “Transaction” includes mergers, acquisitions, affiliations, and agreements affecting health care services in California that involve:
     • transfer of assets (sale, lease, exchange, option, encumbrance, conveyance, or disposition), or
     • transfer of control, responsibility, or governance of assets or operations.
• You must sign into the portal to submit a Material Change Transaction Notice. If you don't have an account, register by clicking Sign In at the top right corner.
• Once signed in, you can submit a new Material Change Transaction Notice (MCN) and view existing MCNs. Drafts not modified or submitted within 90 days may be deleted.
• For questions, contact OHCA at CMIR@hcai.ca.gov.

Optional form you may use, if needed:

• Notice of Material Change Transaction Supplemental Form.pdf