CMS Extends Home Health Agency Moratorium in Select Cities

The Centers for Medicare & Medicaid Services (CMS) has extended its temporary moratorium that bars new home health agencies in select metro areas from enrolling into the federal program.

Effective July 29, the moratorium will continue to prohibit for an additional six months the enrollment of new home health agencies and ambulance service providers within certain metro areas of Florida, Illinois, Michigan, Texas, Pennsylvania and New Jersey, according to a CMS notice published Tuesday in the Federal Register.

The moratorium, which CMS first imposed in July 2013, zeroes-in on geographic areas that the agency has perceived to be “hot spots” for fraudulent activity. Under its terms, no new provider or supplier applications will be approved for CMS’s Medicare, Medicaid and Children’s Health Insurance Program (CHIP).

Since this temporary ban was instituted two years ago, CMS has extended the moratorium period each year by six-month increments.

Initially, the moratorium barred new home health providers from enrolling in CMS programs only in Chicago and Miami, along with ground ambulance suppliers in Houston. In January 2014, CMS expanded the geographic reach of moratorium to include the cities of Fort Lauderdale, Fla., Detroit, Dallas and the Greater Philadelphia area.

Under the moratorium, new home health providers and ambulance suppliers will be barred from enrolling in CMS programs in the following counties:

  • Florida: Broward, Miami-Dade and Monroe counties.
  • Illinois: Cook, DuPage, Kane, Lake, McHenry and Will counties.
  • Michigan: Macomb, Monroe, Oakland, Washtenaw and Wayne counties.
  • Texas: Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller counties.
  • Pennsylvania: Bucks, Delaway, Montgomery and Philadelphia counties.
  • New Jersey: Burlington, Camden and Gloucester counties.

Based upon CMS’s consultation with the relevant State Medicaid Agencies, it has concluded that extending these moratoria will not create an access to care issue for Medicaid or CHIP beneficiaries.

Additionally, CMS also reviewed Medicare data for these areas and found no current problems with access to home health agencies or ground ambulance suppliers.

“Nevertheless, the agency will continue to monitor these locations to make sure that no access to care issues arise in the future,” CMS stated in the Federal Register notice.

Written by Jason Oliva