Which of the following options is NOT a Medicare Certification Option?

The answer identifies that certification through a state agency is not categorized as a Medicare certification option. Medicare offers specific pathways for facilities to achieve certification, primarily through direct certification or by aligning with an established accreditation body that has been granted "deemed status" by Medicare.

Direct certification refers to the process in which a healthcare provider directly engages with Medicare to meet the required standards for participation. Accreditation by a deemed-status provider allows organizations already recognized by Medicare to confer certification to their members upon verifying compliance with Medicare’s quality standards.

The option of forgoing certification suggests that a facility chooses not to pursue any form of certification, which could impact their ability to receive Medicare reimbursement. Hence, while there are various pathways established by Medicare for certification, such as accreditation and direct certification, using a state agency for certification does not exist as a recognized method under Medicare guidelines.