CMS SOM App. G, Tag J-0001

A rural health clinic will be certified for participation in Medicare in accordance

with subpart S of 42 CFR part 405. The Secretary will notify the State Medicaid

agency whenever he has certified or denied certification under Medicare for a

prospective rural health clinic in that State. A clinic certified under Medicare will

be deemed to meet the standards for certification under Medicaid.

Interpretive Guidelines § 491.3

Sections 405.2401 – 405.2404 establish the procedures for certifying a clinic as an RHC

and recertifying existing RHCs, including issuing a Medicare agreement, and the

conditions under which an RHC’s participation in the Medicare program may be

terminated. Section 405.2401(b) requires compliance with the Conditions for

Certification (CfC) in 42 CFR Part 491 in order for an RHC to be certified.

Survey Procedures § 491.3

In general, there are no survey procedures specific to this Condition, with the exception

of the provisions covered in the two standard-level tags below concerning provision of

physician or visiting nurse services (VNS) outside the RHC.

With respect to the other requirements of Part 405, Subpart S, State Survey Agencies

(SA) assess compliance with the remaining CfCs and make recommendations to the CMS

Regional Office (RO). The RO determines whether to issue an initial RHC Medicare

agreement or to terminate an existing RHC Medicare agreement, consistent with the

requirements of 42 CFR Part 405 and as outlined in Chapter 2 of the State Operations

Manual (SOM), sections 2240 - 2249.