Under new regulations, the CMS has the authority to temporarily stop providers from enrolling in Medicare when the risk of fraud is high. The agency so far has not used the power, even now that its watchdog is recommending it, because of the burden of explaining the action.
HHS' inspector general's office last week urged the CMS to impose a moratorium on new Medicare enrollments of independent diagnostic testing facilities in Los Angeles after a citywide inspection found more than one-third of the 132 facilities were not open during the day or not operating from listed addresses.
Regulations unveiled in February under the Patient Protection and Affordable Care Act allow the CMS to impose moratoriums in geographic areas or in specific categories of providers that are deemed at high risk of fraud.