Home Health Agencies (2024)

Home health agencies that provide skilled nursing services may apply for certification to participate in the Medicare/Medicaid programs.The Centers for Medicare and Medicaid Services (CMS) contracts with LARA to evaluate compliance with the federal regulations by conducting certification surveys and complaint investigations.

For initial certification or change of ownership:

• Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC)/Federal Fiscal Intermediary (FI).

• Complete and submit to BCHS:

  • An e-mail confirming a successful electronic submission of your Civil Rights Clearance for Medicare Provider Certification from theOffice for Civil Rights (OCR)
  • Two (2) signed originals Health Insurance Benefit Agreement (CMS-1561)
  • One (1) signed original HHA Survey and Deficiencies Report (CMS-1572A- Only complete numbers 1-10 and 12-20.)
  • Contact Accrediting Organization (AO) to schedule survey (initial only)

For address/location changes:

• Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI within 90 days of the move

* Note-address/location changes should remain within the approved geographic area

For branch site application (one application packet per site):

• Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI.
• Complete BranchApplication (BCHS-SHCS-803) and submit to BCHS.
  Note: Branch site applications must be completed for all proposed sites, including relocations of previously approved sites and newly requested sites.

For a change in administrator, please emailthe following:

• Facility name, address, and provider #
• New administrator full name
• Effective start date of administrator

For submitting correspondence or application documents, please email BCHS_FedDivision@michigan.gov.