Everything Indiana Home Health Providers Need to Know About the July 2026 Medicare Certification Requirement
Effective July 1, 2026, Indiana will implement a new Medicare certification/enrollment requirement for certain health care providers and it’s critical for home health agencies operating in the state to understand what this means and how to comply.
What’s Changing?
Beginning July 1, 2026, the Indiana Health Coverage Programs (IHCP) will require that all home health agencies enrolled with IHCP (Medicaid) must also be enrolled and recognized as Medicare providers in order to continue participating in the Medicaid program. This applies to both:
- Existing agencies, and
- New agencies enrolling in IHCP before the deadline.
This new requirement is outlined in IHCP Bulletin BT202595, issued June 26, 2025.
Why This Matters
Until now, many Indiana home health agencies could operate with Medicaid enrollment alone. After July 1, 2026, if an agency is not actively enrolled with Medicare, it may no longer:
- Be reimbursed by Indiana Medicaid for home health services
- Maintain eligibility for continued IHCP enrollment
In effect, not having Medicare enrollment could lead to loss of Medicaid revenue and disruption of patient care.
What Providers Must Do
Here’s a step-by-step breakdown of what agencies need to do to meet the July 2026 requirement:
- Apply for Medicare Enrollment
Agencies must enroll with Medicare either online via the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) or with a paper CMS-855A Home Health Enrollment Application.
- Undergo Initial Review
Once submitted, the application goes to Palmetto GBA, the Medicare Administrative Contractor (MAC) for Indiana home health and hospice, for review and required screening.
- Complete a Certification Survey
After initial Medicare review, agencies must receive a certification survey from either:
- The Indiana Department of Health (IDOH),
- Or a CMS-approved accrediting organization (AO) such as:
- Accreditation Commission for Health Care (ACHC),
- Community Health Accreditation Partner (CHAP), or
- The Joint Commission (TJC).
- Start Early
Because Medicare enrollment and surveys can take 6–9 months or more, providers should begin the process well before the deadline to avoid delays.
Why the State Is Making This Change?
The goal of the July 2026 requirement is to:
- Standardize quality and compliance standards across home health services.
- Align state Medicaid enrollment with federal Medicare criteria.
- Reduce administrative errors and fraud.
- And ensure quality outcomes for patients receiving home health care.
Top Tips to Prepare
- Start your Medicare enrollment now, don’t wait until the deadline.
- Track your PECOS application carefully and respond promptly to requests for information.
- Schedule your certification survey early or explore accreditation pathways.
- Consider working with experienced Proactive is here to help walk through the certification process.
Written By:
Nichole McClain, RN
Principal Consultant of Home Health Services
Proactive Medical Review
Contact Proactive to learn more about Five-Star Improvement support services and develop a road map to Five-Star success in 2025.