Medicare Regulations & Resources

This page provides basic information about being certified as a Medicare and/or Medicaid home health provider and includes links to applicable laws, regulations, and compliance information. A certified Home Health Agency (HHA) is an agency or organization which is primarily engaged in providing skilled nursing services and other therapeutic services; and has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services which it provides.

Federal

The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation (CoPs) for home health agencies. The guidelines define or explain the relevant statute and regulations and do not impose any requirements that are not otherwise set forth in statute or regulation. 

Regulatory Links

  • Home Health Agency Center (HHAC)
  • Home Health Regulations Conditions of Participation (CoPs)
  • Medicare Learning Network Articles (MLN Matters)
  • Outcome and Assessment Information Set (OASIS)
  • Home Health Prospective Payment System (PPS)
  • Internet Only Manuals (IOMs)
  • Transmittals used to communicate new or changed policies or procedures from CMS

 Home Health Statute (Laws)

 Palmetto GBA 

  • JM Home Health and Hospice – contains links to Claims issues log, ICD-10 resources, LCDs and coverage articles, Medicare Advisories, Medicare forms and more

Quick Links


Enrollment, Participation & Certification

 

Home Health Face-to-Face

  

Fraud and Abuse