The Centers for Medicare & Medicaid Services’ (CMS) moratoria on home health agencies in certain areas of the country is not working, according to some experts.
Certain parts of the country have been under moratoria by CMS for a few years, and home health agencies wanting to start businesses in affected areas have had to apply for a waiver to get certified. However, the broad stroke of the temporary moratoria—and the waiver system—may be punishing to legitimate providers looking to enroll with CMS, Bloomberg BNA reported.
While the moratorium has not been shown to reduce access to care, it has “blocked companies that had been deep in the Medicare enrollment process from becoming fully certified,” according to BNA.
CMS was given the authority to grant temporary moratoriums on providers enrolling in Medicare, Medicaid or the Children’s Health Insurance Program (CHIP), BNA reported. CMS implemented a moratorium on home health care providers in the Chicago, Illinois, and Miami, Florida, areas and ambulance suppliers in the Houston, Texas, area in 2013. The moratorium was expanded to home health care providers in the metro areas of Fort Lauderdale, Florida; Detroit; Houston; and Dallas in 2014.
The moratorium was put in place largely as a measure against overutilization and fraud of the Medicare system, and it is meant to be temporary. Waivers are given on a case-by-case basis, according to BNA, but the process is slow. It can take three to six months to enroll, according the article.
As a result of the moratorium, and with few new home health agencies able to go through the waiver process, existing agencies in affected areas have seen their values rise, Bill Dombi, vice president for law at the National Association for Home Care & Hospice (NAHC), told BNA.
With a new administration at CMS and a push to overturn the ACA within the Republican-controlled Congress, there could be a chance for the moratorium to end, BNA speculated.
“A seniors group, for example, could make the argument that the moratorium has stifled competition and that more HHAs [home health agencies] are needed,” the article reads.
With the seniors demographic ever growing, now might be the right time to push for an end to the moratorium.
Written by Amy Baxter