Starting a Massachusetts Home Health or Home Care Agency?

• Private-pay Home Health Agency — Massachusetts DPH does not issue an HHA license, and Medicare certification is not required simply to conduct home health services.
• Medicare-certified Home Health Agency — completes CMS enrollment, DPH or approved-accreditor survey, and federal certification.
• Non-medical Home Care Agency — falls within the new Chapter 180 framework when the statutory definition applies.

No. Massachusetts DPH states that its laws do not include licensure of Home Health Agencies and no DPH license application is needed merely to open the business.

The agency establishes compliant operations, completes Medicare enrollment through CMS-855A or PECOS, submits DPH certification materials, and completes a state-agency or CMS-approved accreditation survey under 42 CFR Part 484.

The agency must furnish skilled nursing and at least one additional qualifying service. At least one qualifying service must be furnished directly by employees; other qualifying services may be provided under permissible arrangements.

Massachusetts DPH is the CMS State Survey Agency for HHA certification. A Medicare applicant may also qualify for a deemed-status survey through a CMS-approved accrediting organization.

Yes. An HHA must first be Medicare certified before applying to participate in MassHealth, and MassHealth provider enrollment remains a separate process.

No. The new statutory definition of Home Care Agency expressly excludes a Home Health Agency. The two startup paths should not be treated as interchangeable.

Chapter 180 of the Acts of 2026 created Massachusetts's first statewide Home Care Agency licensing framework. EOHHS must issue implementing regulations and establish the mandatory licensing date.

The statute establishes the framework, but regulations and implementation steps are still developing. Agencies should monitor EOHHS notices and prepare their supporting systems without assuming a form or filing deadline until officially released.

Chapter 180 provides for a three-year renewable, nontransferable license once the program is implemented.

The regulations must address background checks, service plans and contracts, insurance, payroll compliance, training, worker safety, emergency preparedness, quality metrics, annual reporting, complaints, supplies, ownership suitability, and financial capacity.

Yes. A referral or placement model may require employment- or placement-agency licensure or registration. Historically, an agency directly employing domestic workers was treated differently, so each business model should be verified with DLS.

No. The registry regulation applies to workers employed by agencies under contract with Aging Services Access Points. Other agencies should verify their applicable screening, registry, and contract requirements.

• Logo creation, customized WordPress website, one year of hosting, and domain registration.
• 500 business cards and 500 tri-fold brochures.
• Massachusetts-specific policies, human-resources documents, admission or client-service documents, and operational forms.
• DPH/CMS Medicare certification preparation for the HHA package, or Chapter 180 licensing-readiness and implementation preparation for the Home Care package.
• Members' area access, customization, ongoing guidance, and applicable updates.

No. Government filings, Medicare or MassHealth enrollment, accreditation, background checks, insurance, office, personnel, survey expenses, software, mailing, and other third-party costs are separate unless expressly included in writing.

Home Health Forms provides customized documents, guidance, and preparation assistance. EOHHS, DPH, DLS, MassHealth, CMS, survey organizations, accreditors, and payers make their own decisions. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all information needed for customization is received. Website development, printing, shipping, and other components may have separate timelines.

Eligibility depends on work completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.