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CMS Announces Six-Month Extension for Medicare Enrollment Moratoria for HHAs

Posted on Friday, January 13, 2017 4:07 PM

A six-month extension has been issued by CMS for statewide moratoria on the enrollment of new Medicare home health agencies, subunits, and branches located in Florida, Illinois, Michigan and Texas. The extension goes into effect January 29, 2017.

The first moratoria for home health agencies was for Miami-Dade County, Florida, Cook County, Illinois, as well as surrounding counties.

The additional counties in Illinois, Florida and counties in Michigan and Texas, will receive extensions and expansions every six months since the first moratoria was issued. CMS expanded the moratoria statewide for enrollment for enrollment of new HHAs in Florida, Illinois, Michigan and Texas on August 3, 2016.

The moratoria will apply to Medicaid and the Children’s Health Insurance Program (CHIP) in each state. However, states will still have the opportunity to opt out if they determine that the imposition of such moratorium would unfavorably impact Medicaid beneficiaries’ access to care.

CMS has confirmed that there’s still a high risk of fraud, waste and abuse beyond the current moratoria areas. These risks are due to circumvention of the moratoria by some providers.

After CMS consulted with the Health and Human Services, Office of Inspector General (HHS–OIG) regarding the extension on new HHAs, the HHS–OIG agrees that a potential for fraud, waste, and abuse continues to exist due to HHAs in selected geographic areas.

CMS maintains its policy that the temporary moratorium does not apply to the following:
• Changes in practice locations
• Changes to provider or supplier information such as phone number, address, or changes in ownership, except changes in ownership of HHAs that require initial enrollments
• An enrollment application that a CMS contractor has already approved, but has not yet entered into the PECOS at the time the moratorium is imposed

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