CMS Imposes Six-Month Moratoria on New Enrollments of Home Health Agencies and Ambulance Suppliers in Three Fraud “Hot Spots”

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Last week, CMS announced temporary moratoria on the enrollment of new home health providers and ambulance suppliers in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) in three fraud “hot spots.”  The Affordable Care Act granted the Secretary of CMS the authority to impose a temporary moratorium on the enrollment of new fee-for-service Medicare, Medicaid, or CHIP providers and suppliers if the Secretary determines that a moratorium is necessary to prevent or combat fraud, waste, or abuse under these programs, but this is the first time that CMS has exercised this authority.

The temporary enrollment moratoria apply to newly-enrolling home health agencies in the Miami and Chicago metropolitan areas and newly-enrolling ground ambulance suppliers in the Houston metropolitan area.  According to CMS, existing providers and suppliers in these areas can continue to deliver and bill for services under the moratoria, but new provider and supplier applications will not be approved in these areas. 

A copy of CMS’s notice is available by clicking here.

Reporter, Ramsey Prather, Atlanta, + 1 404 572 4624, rprather@kslaw.com.

Topics:  Ambulance Providers, CHIP, CMS, Fraud, Healthcare, Home Health Care, Medicaid, Medicare, Moratorium

Published In: Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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