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CMS Moratorium on Home Health Agencies

Under § 424.570 of the Code of Federal Regulations, CMS is permitted to impose temporary moratoria on the enrollment of new Medicare providers and suppliers. These moratoria do not apply to changes in ownership of existing providers and suppliers.

CMS may impose a temporary moratorium on particular types of providers and suppliers or generally in a particular geographic area if CMS determines that there is a significant potential for fraud, waste or abuse. CMS may impose moratoria in 6 month increments and may extend a moratorium for multiple increments. During the moratorium, Medicare will deny new enrollment applications for those providers and suppliers covered by the moratorium.

In January 2014, CMS imposed a moratorium on new home health agencies and Medicare Part B ambulance suppliers in certain geographic areas. CMS extended that moratorium in July 2014 and again on January 29, 2015. There is no indication from CMS when this moratorium may be lifted.

The current extension means that the moratorium will be in effect until at least July 2015. During this moratorium, initial provider enrollment applications and applications for additional practice locations for home health agencies and ambulance suppliers in certain counties will be denied. For home health agencies, Texas counties subject to the moratorium include those in the Dallas and Houston areas. For ambulance suppliers, Texas counties subject to the moratorium include those in the Houston area.

For those wanting to start new home health agencies or expand existing agencies into new counties, the CMS moratorium may affect how and where you can enroll your agency in Medicare. Contact Rivas Goldstein, LLP if you would like more information, or for assistance in the acquisition or expansion of home health agencies.