Differences & Similarities between Home Health Agencies and Nurse Registries – Part 1

Many individuals who consider entering the market as a home health provider in Florida come to us with the same questions: What is the difference between a home health agency and a nurse registry? What factors should I consider when deciding which license to pursue? This series will highlight – in no particular order – what we believe to be the major differences, and similarities, between home health agencies and nurse registries.

1. Billing Medicare & Medicaid.

It is difficult to list in order of priority the differences between these two license types. However, it would seem that a home health agency’s ability to bill Medicare/Medicaid would stand out, not only because of the revenue source, but because of the other factors such enrollment requires, such as the mandatory accreditation, responsibility for a patient’s health and that at least one qualifying service be provided by a direct employee. 

To become enrolled as a Medicare home health provider an organization must be accredited by one of three nationally recognized organizations. The Accreditation Commission for Health Care, the Community Health Accreditation Program and The Joint Commission have been granted “deeming authority” by the Centers for Medicare and Medicaid Services. This authority allows these three organizations to determine whether, or deem that, a home health agency meets the strict requirements to participate in Medicare, as well as each organization’s particular ‘standards’ for operation. Further, in 2008, Florida began the requirement that an organization must be accredited prior to the issuance of a home health agency license. Not all home health agencies in Florida choose to become a Medicare enrolled provider or to provide skilled care. However, to obtain a home health license, whether providing skilled care or whether intending to become Medicare certified, or not, accreditation must be obtained.

A nurse registry cannot bill Medicare or Medicaid, with the exception of billing for participation in Medicaid Waiver programs. The main factor of revenue source serves to differentiate, to a large degree, a home health agency from a nurse registry.

In our next installment in this series, we’ll look at the second distinction between home health agencies and nurse registries: Responsibility for the patient’s health.

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