C799 Health Care Ecosystems Task 1 2025 new
passed task Western Governors University
Healthcare Ecosystems C799 Task 1
College of Health Professions, Western Governors University
Instructor: Ashley Killingsworth
Western Governors University
, Medicare Certification
Centers for Medicare and Medicaid Services (CMS) have developed Conditions of
Participation (CoPs) and Conditions for Coverage (CFCs) that must be met for healthcare
organizations to be able to take part in Medicare and Medicaid programs. These standards aim
to improve the quality of care received by the beneficiaries. CMS also ensures that the agencies
that act to grant accreditation to healthcare organizations meet the standards set out in the
CoPs or CfCs (Centers for Medicare & Medicaid Services, 2023a).
State survey agencies are responsible for assessing healthcare providers. Reinspection
takes place periodically. These inspections determine whether a healthcare organization or
supplier meets the requirements necessary to be eligible for reimbursement through Medicare
or Medicaid programs. The agencies’ findings are reported to CMS, which then determines
eligibility for participation in the Medicare or Medicaid programs (Centers for Medicare &
Medicaid Services, 2024).
Accreditation and Licensing
Each state in the United States requires that healthcare facilities receive approval to
operate through the licensing procedures set out by the individual states. The standards for
licensure include the adequacy of staffing, the quality of the personnel they employ to provide
services, the actual services provided, and the facilities in which they operate (Oachs, 2020).
To be eligible for reimbursement for services by Medicare and Medicaid, a healthcare
organization must be accredited. Accreditation is a voluntary process, meaning that the
organization meets standards set out by an independent agency through periodic examination
of the organization’s quality of work against a pre-established set of criteria (Oachs, 2020).
passed task Western Governors University
Healthcare Ecosystems C799 Task 1
College of Health Professions, Western Governors University
Instructor: Ashley Killingsworth
Western Governors University
, Medicare Certification
Centers for Medicare and Medicaid Services (CMS) have developed Conditions of
Participation (CoPs) and Conditions for Coverage (CFCs) that must be met for healthcare
organizations to be able to take part in Medicare and Medicaid programs. These standards aim
to improve the quality of care received by the beneficiaries. CMS also ensures that the agencies
that act to grant accreditation to healthcare organizations meet the standards set out in the
CoPs or CfCs (Centers for Medicare & Medicaid Services, 2023a).
State survey agencies are responsible for assessing healthcare providers. Reinspection
takes place periodically. These inspections determine whether a healthcare organization or
supplier meets the requirements necessary to be eligible for reimbursement through Medicare
or Medicaid programs. The agencies’ findings are reported to CMS, which then determines
eligibility for participation in the Medicare or Medicaid programs (Centers for Medicare &
Medicaid Services, 2024).
Accreditation and Licensing
Each state in the United States requires that healthcare facilities receive approval to
operate through the licensing procedures set out by the individual states. The standards for
licensure include the adequacy of staffing, the quality of the personnel they employ to provide
services, the actual services provided, and the facilities in which they operate (Oachs, 2020).
To be eligible for reimbursement for services by Medicare and Medicaid, a healthcare
organization must be accredited. Accreditation is a voluntary process, meaning that the
organization meets standards set out by an independent agency through periodic examination
of the organization’s quality of work against a pre-established set of criteria (Oachs, 2020).
