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What do I need to know about starting a home health agency in NY?

Entrepreneurs and business leaders looking to start a home healthy agency in New York are looking at a business opportunity that can provide significant financial incentive while also helping to better the community by providing care with dignity to those in need. Business leaders can better ensure success by planning for the following before moving forward with this business endeavor.

Step 1: Do I need a license?

There are certain professions that require special licensure. This is one of them. Entrepreneurs will need to receive licensure from the New York State Department of Health’s Division of Home and Community Based Services in order to open a home health agency in the state. This will require information about the business such as the chosen business structure (sole proprietorship, partnership, corporation, etc.) and types of services provided (nursing, physical therapy, nutrition, personal care, etc.).

Step 2: Do I know the regulations?

Home health agencies are more than just businesses, they can serve as healthcare providers. As a result, the business triggers many healthcare related regulations. Some examples include:

  • Anti-Kickback Statute (AKS). This is a federal regulation that makes it illegal to provide financial or other forms of remuneration in exchange for medical services. So a home health agency must be very careful in how they encourage or receive referrals from a hospital or physician group.
  • Medicare fraud. It is always wise to keep good records when billing another business, but this is especially true when that business is Medicare. The government will aggressively investigate any allegations of false billing or billing for medically unnecessary services.

A failure to comply with these and other applicable regulations can result in more than just a fine and the proverbial slap on the wrist. Because these are criminal laws, they can also result in potential imprisonment. Business owners can mitigate these risks by having a compliance program in place before beginning their operation.