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Medicare Accreditation for Home Health Care

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Before any Home Health Care Agency

is allowed to bill Medicare it must be Medicare Certified

by the Center for Medicare & Medicaid Services (CMS) and Medicare Accredited by one of 3 Accrediting Bodies
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Today, the great majority of home health care agencies obtained Medicare Certification by undergoing Medicare Accreditation with one of the three major Medicare Accrediting Bodies: the Community Health Accreditation Program (CHAP), The Joint Commission  (“JTC”) (formerly known as the “Joint Commission on Accreditation of Health Care Organizations or “JCAHO”) or Accreditation Commission for Health Care, Inc (ACHC)

When Home Health Agencies were first being established in the 60’s and 70’s, Medicare Certification was carried out exclusively by the states which performed inspections and reported results to CMS.

Beginning in late 1960s the Community Health Accreditation Program began Medicare Accrediting Home Health Care Agencies after they had been Medicare Certified.  Medicare Accreditation thus began as an “add-on” seal of approval which helped home health care agencies advertise their expertise and distinguish them from competitors. JCAHO followed CHAP’s lead several years later.

The process of Medicare Certification followed by Medicare Accreditation stayed consistent until 1992, when CHAP was granted ‘deemed status” by CMS. This meant that a CHAP Medicare Accreditation Survey could take the place of the Medicare Accreditation Surveys previously administered by the states instead of being Medicare Certified and then Medicare Accredited, home health care agencies would first be Medicare Accredited and then Medicare Certified dependent upon review “automatically by CMS.” In 1993 JCAHO also obtained deemed status on a national basis. ACHC achieve deemed status in 2009.
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Today CHAP (Community Health Accreditation Program) is by a good margin the largest of the three Medicare Accrediting Bodies in terms of Medicare Accreditation for home health care agencies.

Gradually, states stopped performing Medicare Accreditation surveys. Today, there are only a handful that still do.

The “seal of approval” that Medicare Accrediting bodies provide has increasingly become more important as it is required by many Medicare HMO, ACOs and insurance companies.

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