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Due to the delay in obtaining Medicare certification, those agencies with provider numbers rose in value. A market for Medicare certified home health agencies developed, where entities were created for the sole purpose of “flipping” them to others for a significant profit. Medicare viewed such transactions as abusive. Ultimately the party who turned out to be the operator of the entity was not the party who underwent the certification process. As a result, changes were made and now the “36 month rule” applies to certain transfers of home health agencies.