Medicaid Provider Certification

The total number of Medicaid recipients who received medical care more than doubled between 1985 and 2008. More facilities need to become Medicaid certified to increase access to care for these individuals.

Benefits

• Certification ensures that eligible health care facilities are in compliance with federal standards of quality care. This process holds providers accountable for providing safe, effective service to patients while ensuring important protections for staff.

Considerations

• The Centers for Medicare and Medicaid Services (CMS) provider certification varies based on the type of provider. For example, the certification process will differ slightly for a home health agency as opposed to a hospital or hospice. Medicaid requires nursing facilities to meet basically the same requirements that skilled nursing facilities participating in Medicare must meet.

Features

• Although certification is different based on facility type, generally certification consists of a facility survey conducted by a state surveyor. The surveyor will visit the facility and inspect a variety of things such as facility cleanliness and patient care quality.

Identification

• Following guidelines for your facility type is crucial to successful certification. CMS provides detailed information by type of business in their web-based state operations manuals.