CMS Extends Targeted Home Health Moratorium

The Centers for Medicare & Medicaid Services (CMS) announced today that it is issuing a six-month extention of its moratoria for newly enrolling home health agencies in specified geographic regions, effective immediately.

CMS used this Affordable Care Act tool twice before as part of its efforts to fight fraud, safeguard taxpayer dollars and ensure access to care is not interrupted.  

The moratorium extension does not extend nationally, but zeroes in on newly-enrolling home health agencies in the metropolitan areas of Chicago, Fort Lauderdale, Detroit, Dallas, Houston, and Miami.

“The extension is necessary because the significant potential for fraud, waste and abuse continues in these areas,” said CMS Administrator Marilyn Tavenner, in a news release.

Factors that CMS considered in imposing the provider enrollment moratoria include a disproportionate ratio of providers and suppliers relative to beneficiaries, and law enforcement activity in these areas.  

Existing providers and suppliers can continue to deliver and bill for services, but no new provider and supplier applications will be approved in these areas.

Also included in the extended moratoria are ground ambulance suppliers in Houston and Philadelphia.

CMS may lift the moratoria earlier or extend it another six months by issuing another notice in the Federal Register.  

“During the moratoria period, CMS and the affected states will continue to monitor access to care to ensure that Medicare, Medicaid and CHIP beneficiaries are receiving the services they need,” CMS says.

Read the moratorium in the Federal Register here

Written by Cassandra Dowell

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