CMS Issues Second Wave of Home Health Moratoria

Following in the footsteps of its initial home health moratorium last year, the Centers for Medicare & Medicaid Services (CMS) will now bar new agencies from enrolling in four additional U.S. metros. 

CMS today announced a new temporary moratoria on the enrollment of home health agencies in Fort Lauderdale, Detroit, Dallas and Houston, as well as the enrollment of new ground ambulance suppliers in the Greater Philadelphia area.

The federal agency also extended for six-months the current moratoria it announced back in July 2013 for home health agencies in Chicago and Miami, as well as ground ambulance suppliers in Houston from enrolling in CMS’s Medicare, Medicaid and Children’s Health Insurance Program operations. 

This second wave of barring new provider enrollment stems from CMS efforts to “fight fraud and safeguard taxpayer dollars while ensuring patient access to care is not interrupted,” the agency stated in a release.

“Our first use of the moratoria put fraudsters on notice that we are using all available tools, including these moratoria, to combat fraud, waste and abuse in our health care programs, while maintaining patients’ access to care,” said CMS Administrator Marilyn Tavenner.

Existing providers in these targeted areas can continue to deliver and bill for services, however, CMS will not approve new provider or supplier applications in these metros. 

“CMS also consulted with the Health and Human Services Office of Inspector General and the Department of Justice, and found that fraud trends warranted a moratorium on home health providers and ambulance suppliers in these geographic areas,” CMS stated in its release issued Thursday.

The new moratoria and six-month extension of the existing moratoria will begin Friday, January 31, and are expected to remain in place for a period of six months, according to CMS. 

“Today’s announcement shows we are continuing our intense fight against fraud, waste and abuse in these vital healthcare programs,” Tavenner said.

A notice in the Federal Register may be found here.

Written by Jason Oliva