The Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) recently announced it will extend a statewide, temporary moratorium on enrollment of new non-emergency ambulance providers and home health agencies in Texas. The agency intends the freeze to cut down on the risk of fraud, waste and abuse within the system.
Why did the CMS decide to issue a moratorium on home health care agencies? The agency based the decision on a review of various qualitative and quantitative factors. In addition to a review of its own data, the CMS also took into consideration data gathered from the Department of Health and Human Services’ Office of Inspector General and the Department of Justice to support the decision. This evidence indicated the likelihood for fraud in this area of healthcare was dangerously high. As such, the agency has frozen the ability to start up a new practice in these specific fields.
Does the CMS have the power to stop the creation of new home health care agencies? In short, yes. The Social Security Act provides the CMS with the power to impose a temporary moratorium on the creation of new Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) providers.
How does this impact current home health agencies? The moratorium should not impact the current practice of a home health agency in Texas. The agency specifically states that the moratorium does not apply to a change in location, provider contact information or, in many cases, a change in ownership.
When will the moratorium end? The moratorium is set to run for six months. At that time, it is possible the agency will choose to implement an additional, six-month extension.