Michigan Home Health & Hospice Startup

Licensing in Michigan

Michigan has no state license for home health agencies. Medicare certification, run by LARA's Bureau of Survey and Certification as CMS survey agent, is the credential. Hospices need a state license from LARA's Bureau of Community and Health Systems under MCL 333.21419. A CMS moratorium (Federal Register 2026-09717 for HHAs, 2026-09718 for hospices) freezes new enrollments.

License routes we cover in Michigan

Medicare-Certified Home Health Agency (HHA)

Agencies billing Medicare or Medicaid for skilled nursing, therapy, or aide care. No state license; certification runs through LARA-BSC and CMS.

Michigan State Hospice Agency License

Any hospice giving end-of-life care. A LARA-BCHS state license is required before or with Medicare enrollment, under MCL 333.21419 and R 325.45101 et seq.

Michigan State Hospice Residence License

A licensed hospice that also runs a residential inpatient facility. Needs the same state license plus per-bed fees and other agency approvals.

Non-Medical / Private-Duty Home Care Agency

Agencies offering only personal care, companion, or homemaker help, no skilled staff. Michigan does not license these. Meet business, insurance, and Medicaid EVV rules.

How we get you licensed

Watch the CMS Moratorium Window

Applications filed on or after May 13, 2026 are auto-denied; the freeze runs to about November 13, 2026. Use this time to form the entity, write policies, and recruit staff. Earlier applications that already have a Document Control Number are grandfathered.

Form the Legal Entity and Get Business Credentials

Register a Michigan LLC or corporation with LARA's Corporations Division. Get an EIN and an NPI through NPPES. Buy general and professional liability insurance. Hospice applicants open a LARA eLicense account at bchs_elicense.apps.lara.state.mi.us.

Build CMS-Compliant Policies and Clinical Structure

Write a policy manual that meets the Conditions of Participation (42 CFR Part 484 for home health, Part 418 for hospice). Hire an Administrator and an RN Director of Patient Services. Hospices also need a governing body, medical director, and interdisciplinary team under R 325.45101 et seq.

Hospice: File the State License Application with LARA-BCHS

Complete form LARA-SLACR (04/2025), once called LARA-SLACR-101, and email it to LARA-BCHS-NLTCSLS@michigan.gov with the $2,500 fee (plus $5 per bed for a residence). Electronic payments add a 2% fee. LARA-BCHS surveys the facility; MCL 333.20155 requires a visit at least every three years.

Submit CMS-855A to NGS and Request the LARA Survey

When the freeze lifts, file the CMS-855A through PECOS to National Government Services (NGS), the Jurisdiction 6 MAC for Michigan. Email LARA-BSCSupport@michigan.gov your Civil Rights Clearance from the HHS Office for Civil Rights and the signed Health Insurance Benefit Agreement (CMS-1561), then request a survey or submit your accreditation org's survey report and deeming letter.

Pass the Survey and Activate Medicare

Non-deemed applicants get an unannounced LARA-BSC survey against the Conditions of Participation. In FY2026 LARA-BSC ranks initial surveys low priority, so deemed status through ACHC, CHAP, or The Joint Commission is faster. After fixes, NGS finalizes enrollment and billing can start. Enroll in MDHHS's CHAMPS for Medicaid and meet the EVV requirement.

Key Michigan requirements

No state home health license; Medicare certification runs through LARA-BSC (CMS survey agent) under 42 CFR Part 484.

Hospices need a state license under MCL 333.21419 ($2,500 fee), usually before Medicare enrollment.

An RN must serve as Director of Patient Services or equivalent clinical lead; a qualified Administrator is required.

Send Civil Rights Clearance (HHS Office for Civil Rights) and the signed CMS-1561 agreement to LARA-BSCSupport@michigan.gov.

Electronic Visit Verification (EVV) is required for all Michigan Medicaid home care before you bill.

Enroll within six months after the freeze and face 'high' screening: site visits and fingerprinting for owners of 5% or more.

Traps that catch new owners

The CMS moratorium (May 13, 2026) auto-denies new CMS-855A filings; only earlier ones with an NGS Document Control Number survive.

In FY2026 LARA-BSC ranks initial surveys low priority; without accreditation you may wait indefinitely. Deemed status through ACHC, CHAP, or The Joint Commission fixes this.

CMS named Michigan a high-fraud-risk area for home health (Federal Register 2026-09717). Post-freeze applications face 'high' screening with site visits and owner fingerprinting, so keep airtight records.

Michigan Home Health Launch & Medicare Certification: Fixed-Price Application Support

$2,495.00

View details

Michigan licensing FAQs

Does Michigan require a Certificate of Need (CON) for a new home health agency?

No. Michigan's CON statute (MCL 333.22203) covers services like cardiac catheterization, MRI, radiation therapy, surgery, and psychiatric beds, not home health agencies. CON applies to hospitals, nursing home beds, and set covered services. Still, confirm with a Michigan healthcare attorney for your setup.

Can we submit a Medicare enrollment application right now during the moratorium?

No. The nationwide moratorium runs from May 13, 2026 to about November 13, 2026, and applications filed during it are auto-denied. Use the window to form the business, write policies, hire staff, and pursue accreditation so your CMS-855A is ready when it lifts.

Do we need a Michigan state license before starting Medicare enrollment?

Home health agencies have no state license; certification through LARA-BSC and CMS is the only credential. Hospices must first hold a LARA-BCHS state license (form LARA-SLACR 04/2025, $2,500 fee). The two run in parallel, but the state license must be ready before the Medicare survey.

Michigan Home Health, Hospice & Home Care Startup

Licensing in Michigan

Michigan Department of Licensing and Regulatory Affairs (LARA)