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CMS Allows Home Health Moratorium to Expire

Posted on Monday, February 4, 2019 1:16 PM

As of January 30, 2019, there are no active Medicare Provider Enrollment Moratoria in any State or U.S. territories.

CMS has indicated to NAHC that it let the moratoria expire because it has other tools available to address program integrity concerns.  Here is what CMS explained:

Consistent with the statutory authority, the moratoria were intended to be a “temporary” tool used to combat fraud, waste, and abuse in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).  CMS’ implementation of additional and new safeguard measures in place of the moratoria, will continue the agency’s commitment and focus on protecting beneficiaries from harm and ensuring taxpayer funding is used appropriately to protect resources from fraud, waste, abuse, and avoid other improper payments in both Medicare and Medicaid.

CMS has not indicated whether it has any plans to reinstate the moratoria in the future. However, CMS did reference NAHC to the pending proposed rule that modifies standards for moratoria when asked about risks of starting a new HHA and getting short of the point where Medicare certification is permitted when any new moratoria is imposed. 81 Fed. Reg. 10720 (March 21, 2016). In the past, many parties invested in creating an HHA only to be stopped from Medicare participation because CMS imposed a provider moratorium before the party fully completed the certification process.

NAHC’s assessment is that the near-term risk of a new moratorium is remote at most. That would mean the door is open for new HHAs in the previously targeted states or any new states. However, it would be prudent to move soon to submit an application and to stay attentive to advancing the certification process.

Source: NAHC

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