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Federal Certification to Participate in Medicare/Medicaid

Federal Certification to Participate in Medicare/Medicaid

Initial Certification

To voluntarily become a Medicare certified provider, you will need to complete the following steps and submit the paperwork electronically to LARA-BSCSupport@michigan.gov, unless otherwise noted in the instructions.

  • Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC).
  • The MAC will provide you a recommendation letter once the initial review is complete.
  • An e-mail confirming a successful electronic submission of your Civil Rights Clearance for Medicare Provider Certification from the Office for Civil Rights (OCR).
  • A signed “Health Insurance Benefit Agreement” (CMS-1561)
  • A copy of the nursing home’s patient transfer agreement.
  • A letter notifying the Bureau of Survey and Certification (BSC) that the Nursing Home is ready for their federal certification survey.
    • Before letter is submitted ensure occupancy has been granted by the Health Facilities Engineering Section, a state license has been issued, and at least 8 residents are receiving care.
    • The letter must include the date each resident was admitted. 
    • An unannounced survey will be conducted no sooner than 6 weeks after the criteria is met.
  • Once all documents have been received and survey has been conducted, BSC will review and forward the application to the MAC for final determination and issuance of Medicare provider number.
  • Please note, this process can take up to 30-60 days from the day of receipt by the MAC.

Change of Ownership (CHOW)

A Nursing Home will need to complete the following steps and submit the paperwork electronically to LARA-BSCSupport@michigan.gov, unless otherwise noted in the instructions.

  • Ensure all state licensing Change of Ownership requirements have been completed and approved prior to submitting the federal request.
  • Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC).
  • The MAC will provide you a recommendation letter once the initial review is complete.
  • An e-mail confirming a successful electronic submission of your Civil Rights Clearance for Medicare Provider Certification from the Office for Civil Rights (OCR).
  • A signed “Health Insurance Benefit Agreement” (CMS-1561)
  • A “Long-Term Care Facility Application for Medicare and Medicaid” (CMS-671)
  • A copy of the nursing home’s patient transfer agreement
  • A copy of the bill of sale or other legal documentation of change of ownership
  • Once all documents have been received, the Bureau of Survey and Certification will review and forward the application to the MAC for final determination.
  • Please note, this process can take up to 30-60 days from the day of receipt by the MAC.

Contact Us

Bureau Phone: 517-284-0193

Bureau Fax Number: 517-763-0214

Help for general questions: LARA-BSCHelp@michigan.gov

Certification Support email (document submission): LARA-BSCSupport@michigan.gov