SMQT, SMQT Study Guide, SMQT- Survey &
Certification Background, SMQT Study Guide, SMQT-
Surveyors & Survey Teams, SMQT Study Guide,
SMQT- Fraud & Abuse, SMQT Study Guide
CLIA Laboratories
Each accrediting organization that has received deeming authority
(under CLIA) is approved for specific laboratory specialties /
subspecialties.
Refer to Chapter 6 of the State Operations Manual (SOM) for additional
information on accrediting organizations.
,CLIA Laboratories approved for distinct specialties and subspecialties:
- American Association of Blood Banks
- American Osteopathy Association
- American Society of Histocompatibility & Immunogenetics
- The Joint Commission
- College of American Pathologists
- Commission on Office Laboratory Accreditation
CERTIFICATION
Certification is a recommendation made by the State Agency (SA) on
the compliance of providers and suppliers with the conditions of
participation, requirements, and conditions of coverage.
State Agencies officially certify the findings that health care entities do
the following:
- Meet the Act's provider or supplier definitions
- Comply with standards required by Federal regulations
,CMS Headquarters
- Located in Baltimore, MD
- Overall policy-making responsibility is centralized at CMS Baltimore
headquarters
- In Baltimore HQ, all aspects of the Medicare program and oversight of
the State Medicaid programs are coordinated
- Monitoring, surveillance, & overall administrative control of the
certification process including its financial aspects
- Establishing operational policy for the certification process
- Conveying operational instructions and official interpretations of
policy to the State Agencies (SA) and the CMS regional offices (ROs)
CMS Regional Offices (RO's)
Responsible for assuring health care providers and suppliers
participating in the Medicare + Medicaid programs meet applicable
Federal requirements.
, 10 CMS Regional Offices (pt 1)
- Interpret CMS guidelines, policies, & procedures applicable to
certification activities
- Provide liaison, direction, & technical assistance to SAs in the day-to-
day management of the certification process
- Evaluate the performance of State agencies (SAs) in interpreting &
applying health & safety standards, their assessments of providers &
suppliers for compliance with standards, & their use of appropriate
administrative procedures
- Make final determinations of provider and supplier eligibility for
participation in the Medicare program.
- Assemble information on all determinants of eligibility
- Approves, denies, or terminates provider agreements and supplier
participation
- Arrange for FI tie-in with new providers
Certification Background, SMQT Study Guide, SMQT-
Surveyors & Survey Teams, SMQT Study Guide,
SMQT- Fraud & Abuse, SMQT Study Guide
CLIA Laboratories
Each accrediting organization that has received deeming authority
(under CLIA) is approved for specific laboratory specialties /
subspecialties.
Refer to Chapter 6 of the State Operations Manual (SOM) for additional
information on accrediting organizations.
,CLIA Laboratories approved for distinct specialties and subspecialties:
- American Association of Blood Banks
- American Osteopathy Association
- American Society of Histocompatibility & Immunogenetics
- The Joint Commission
- College of American Pathologists
- Commission on Office Laboratory Accreditation
CERTIFICATION
Certification is a recommendation made by the State Agency (SA) on
the compliance of providers and suppliers with the conditions of
participation, requirements, and conditions of coverage.
State Agencies officially certify the findings that health care entities do
the following:
- Meet the Act's provider or supplier definitions
- Comply with standards required by Federal regulations
,CMS Headquarters
- Located in Baltimore, MD
- Overall policy-making responsibility is centralized at CMS Baltimore
headquarters
- In Baltimore HQ, all aspects of the Medicare program and oversight of
the State Medicaid programs are coordinated
- Monitoring, surveillance, & overall administrative control of the
certification process including its financial aspects
- Establishing operational policy for the certification process
- Conveying operational instructions and official interpretations of
policy to the State Agencies (SA) and the CMS regional offices (ROs)
CMS Regional Offices (RO's)
Responsible for assuring health care providers and suppliers
participating in the Medicare + Medicaid programs meet applicable
Federal requirements.
, 10 CMS Regional Offices (pt 1)
- Interpret CMS guidelines, policies, & procedures applicable to
certification activities
- Provide liaison, direction, & technical assistance to SAs in the day-to-
day management of the certification process
- Evaluate the performance of State agencies (SAs) in interpreting &
applying health & safety standards, their assessments of providers &
suppliers for compliance with standards, & their use of appropriate
administrative procedures
- Make final determinations of provider and supplier eligibility for
participation in the Medicare program.
- Assemble information on all determinants of eligibility
- Approves, denies, or terminates provider agreements and supplier
participation
- Arrange for FI tie-in with new providers
