Building on strong anti-fraud efforts already underway, Centers for Medicare & Medicaid Services’ Administrator Marilyn Tavenner today announced temporary moratoria on the enrollment of new home health provider and ambulance supplier enrollments in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) in three fraud “hot spot” areas of the country, including two Florida counties. The goal of the temporary moratoria is to fight fraud and safeguard taxpayer dollars, while ensuring patient access to care. Authority to impose such moratoria was included in the Affordable Care Act, and CMS is exercising this authority for the first time.
Under the moratoria, existing providers and suppliers can continue to deliver and bill for services, but no new provider and supplier applications will be approved in these areas for all three programs. 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 (see list of affected counties below). CMS announced the temporary, six-month moratoria in a notice issued today in the Federal Register. (more…)