Senators Praise Home Health Moratorium on Medicare Providers

Three Republican senators voiced support Wednesday for the temporary moratorium the Centers for Medicare & Medicaid Services (CMS) recently placed on certain cities for new home health care providers to be enrolled in Medicare.

Senators Orrin Hatch (R-Utah), Chuck Grassley (R-Iowa), and Tom Coburn (R-Okla.) welcomed the action, a tool provided under the Affordable Care Act with an aim of reducing waste, fraud, and abuse within the Medicare program. 

Under the ACA, CMS has the authority to impose a temporary enrollment moratorium on new Medicare providers and suppliers when the agency determines there is a significant potential for fraud or abuse by the applicant type or geographic area.

There are now home health moratoria on Chicago and Miami, and another for ground ambulance suppliers in Houston—three “hot spots” for Medicare fraud. Existing providers and suppliers can still deliver services and bill Medicare for reimbursement, but no new provider or supplier applications will be approved for Medicare or Medicaid.

“I applaud CMS Administrator Marilyn Tavenner and her team for using authorities under current law to temporarily halt the enrollment of new Medicare providers or suppliers in key areas that are especially subject to fraud, waste, or abuse,” said Coburn in a statement. “I am glad to see CMS follow recommendations from the Inspector General, as well as myself and colleagues, that they should use this targeted tool to protect taxpayers and beneficiaries. While reducing fraud will not solve Medicare’s broader financing challenges, using the full range of authorities and tools to reduce fraud is an important responsibility in managing the program.”

The senators have requested multiple times in the past three years for CMS to take advantage of its authority to impose temporary moratorium. 

Written by Alyssa Gerace

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