Request to Assign Permit CMO

​​​​​Last updated:  June 12, 2020

Request for Approval to Assign a Permit
Care Management Organization
Chapter 648, Wis. Stat.

Note: The following addresses are links to the statutes in pdf format:

A care management organization requesting approval to assign their permit pursuant to s. 46.2895 (4) (r), and ch. 648, Wis. Stat., must obtain OCI approval. Please complete and return the request for approval to assign a permit for a care management organization (link provided below). Any questions about the request should be directed to Mr. Richard Hinkel (608-267-7910).

No request will be addressed until all items on the request form have been completed.

Request for Approval Packet

The request for approval packet is available to be downloaded below.

Request for Approval Packet

Permit Assignment - Balance S​heet and Obligation Listing (Excel)​​

Please direct questions to (Include your name, phone number, and email address.)