If You Have Complaints about Wisconsin Health Care

Information about Division of Quality Assurance (DQA)

DQA Web Pages

DQA Facility Directories

DQA Provider Training

DQA Numbered Memos

DHS Forms

WI Nurse Aide Training and Registry Info

Caregiver Program/ Background Checks

WI Adult Programs Caregiver Misconduct Registry

WI Medicaid Provider Information

Home Health Agencies (HHAs)
Medicare Certification Materials

Introduction | Rules_&_Regulations | Providers | Contacts | What's_Happening | Publications | Related Sites

For questions regarding these materials, you may E-mail the 
Division of Quality Assurance

For a home health agency to be certified for Medicare and Medicaid billing, it must first secure its Wisconsin license to operate. Please see Wisconsin Licensing Information to Operate a Home Health Agency (exit DHS)

Wisconsin Medicaid provider certification packets - Scroll down to Home Health Agencies

For federal Medicare certification requirements, review the following:

• Code of Federal Regulations
  Conditions of Participation, Home Health Agencies (exit DHS)

• CMS State Operations Manual (exit DHS)

  • Chapter 2 (exit DHS; PDF) - Go to section 2202, page 157 OASIS Requirements

    • OASIS - HHAs seeking Initial Certification should review 2202.10 A thru F

  • Appendix B - Guidance to Surveyors: Home Health Agencies (exit DHS; PDF)

• Forms - Complete and send to: Home Health Licensing Specialist, Provider Regulation and Quality Improvement Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.
  Do NOT send anywhere else.

  • Home Health Agency Survey and Deficiencies Report (CMS-1572) (exit DHS; PDF, 50 KB)

  • Health Insurance Benefit Agreement (CMS-1561) (exit DHS; PDF)

  • Expression of Intermediary Preference (PDF, 12 KB)

  • Medicare Certification Civil Rights Information Request Form (exit DHS; Word) - Please review carefully and fill out and submit all requested items

• Centers for Medicare and Medicaid Services (CMS)
  OASIS Home Page

  • Licensed Home Health Agencies seeking Medicare and Medicaid certification should in particular review the OASIS Regulations, the OASIS User's Manual , and CMS Memorandum S&C- 01-02 Application of OASIS to Medicare Beneficiaries

• CMS Survey & Certification Letters - ongoing updates for OASIS and Home Health Agencies

• OASIS Transmission Guidance for Newly Licensed Home Health Agencies Applying for Medicare Certification (PDF, 21 KB)

• AT&T Global Network Dialer Download and Installation Instructions - Contact the QIES Tech Support Office (exit DHS)

• Outcome and Assessment Information Set (OASIS) Resources (PDF, 30 KB)

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Last Updated: June 30, 2008