Relationship of Survey Date to Date of Initial Medicare Approval

1014 - Relationship of Survey Date to Date of Initial Medicare Approval (Rev. 1, 05-21-04) A provider or supplier cannot begin to have its services covered and reimbursed by Medicare until the date on which it is found, via the certification process, to be in compliance with all federal requirements, including compliance with all applicable CoPs or in substantial compliance with the requirements for SNFs and NFs, or in compliance with the CfCs if it is a supplier (42 CFR 489.13). A laboratory with a CLIA registration certificate is an exception to this rule. Other exceptions are CMHC’s and FQHC’s. The effective date for CMHC and FQHC participation is the date the RO signs the CMHC or FQHC agreement and determines that all medical requirements, including environmental requirements, are met. (See SOM, Chapter 2, §2004.) In most cases, it usually is impossible to schedule and complete a survey, i.e., ascertain actual compliance with all applicable requirements, on the date a new institution opens its doors. The institution generally must operate for a short initial period without Medicare payment for its services.