Community Mental Health Centers / Partial Hospitalization Programs (CMHC/PHP)

This is a Medicare certification program for a partial hospitalization program for community mental health providers. These programs include services for mental illness and substance abuse disorders.

Notices/Updates

License/Certification Requirements

Certification requires submission of an application and other documentation. The Centers for Medicare and Medicaid Services (CMS) contracts with the state to perform site-visits. Also, some community mental health providers or partial hospitalization programs may require licensure as a "health care clinic". Additional information on licensure as a health care clinic can be obtained from the Agency's Health Care Clinic Unit.

Regulations/Guidance

Florida has outpatient licensure requirements only for substance abuse services and health care clinics. The Department of Children and Families regulates substance abuse services, and the Agency's Health Care Clinic Unit licenses health care clinics. Unless required by the "Health Care Clinic Act", there are no state licensing requirements imposed by the Agency.

• 42 CFR, Part 410, Subpart A, Sections 410.1-.5
• 42 CFR, Part 485, Subpart J, Sections 485.900-.920
• CMS State Operations Manual [PDF]
  (See Sections 2250-2252P)
• Interpretive Guidelines [223KB, PDF]

Forms/Information

• Applicant Instructions [138KB, PDF]
• Health Insurance Benefit Agreement - CMS Form 1561 [PDF]
• Medicare Administrative Contractor Choice Form [190KB, PDF]
• Crucial Data Extract – Attachment D [7KB, PDF]
• Attestation Statement [9KB, PDF]
• Medicare Certification Civil Rights Information Request Form [PDF]
• Assurance of Compliance - HHS Form 690 [PDF]

Civil Rights Information and Forms

Note: Providers now have the option of answering all questions and submitting the civil rights clearance package on line.