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Civil Rights Clearance for Medicare Provider Applicants

If you are a health care provider seeking initial Medicare Part A certification and/or undergoing a change of ownership (CHOW), you will need a civil rights clearance from the Office for Civil Rights (OCR) to be certified as a Medicare provider by the Centers for Medicare and Medicaid Services (CMS).  There are two ways to apply for a civil rights clearance:

  1. Go to OCR’s Medicare Certification Portal to submit your application on line.  The Portal has guidance and sample policies to assist you to easily complete the application.  If you cannot complete the application in one sitting, you will be able to save your work and come back later.   Once you have completed your application for civil rights clearance via the Portal and hit the “submit” button, you will receive an e-mail stating that you have submitted your civil rights documents.  Please give a copy of this e-mail to your State Agency representative.  This e-mail is NOT your clearance, but it will show the State Agency that you have started the civil rights clearance process.  The e-mail from OCR is all your State Agency needs regarding civil rights documentation in order to continue the Medicare application process.  Once OCR has had an opportunity to review your submission, possibly request changes, and approve it, you will receive a final civil rights clearance letter.  We ask that you share the clearance letter with your State Agency representative.
  1. If you prefer to submit your application via hard copy, you must complete the Civil Rights Information Request and submit the Information Request and your required civil rights policies and procedures to your local State Agency along with your other Medicare Part A application materials. 
    1. Civil Rights Information Request for Medicare Certification Form [PDF|189KB]


    1. Civil Rights Information Request for Medicare Certification Form Package [PDF|2.38MB] (includes sample policies and additional guidance on completing the form and required attachments)

For step-by-step assistance in filling out the application form, click here.

CMS has legal authority under Title XVIII of the Social Security Act to require health care providers to meet the legal requirements of the civil rights nondiscrimination statutes and regulations enforced by OCR in order to participate in the Medicare Part A program. These statues and regulations ensure that eligible persons have equal access to quality health care regardless of their race, color, national origin, disability, or age. The specific statutes include: Title VI of the Civil Rights Act of 1964 (which prohibits discrimination on the basis of race, color and national origin); Section 504 of the Rehabilitation Act of 1973 (which prohibits discrimination on the basis of disability); and The Age Discrimination Act of 1975 (which prohibits discrimination on the basis of age).

Click here for more detailed technical assistance, more information on civil rights, and  the same civil rights sample policies and procedures.

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