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August 01, 2016 12:00 AM

CMS extends ban on new home healthcare agencies in select markets

Virgil Dickson
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    The CMS has extended a moratorium on new Medicare home-healthcare agencies and ambulance suppliers in some states. It's part of an ongoing effort to curb fraud.

    The agency will extend the temporary ban for six months. It affects new Medicare Part B non-emergency ground ambulance suppliers in New Jersey, Pennsylvania and Texas. Home health agencies in Florida, Illinois, Michigan and Texas and their providers additionally are prohibited from enrolling in Medicaid and CHIP.

    The CMS relied on law enforcement's experience with fraud as well as data analysis in determining how and where to impose the original moratoriums, which became effective July 31, 2013. The bans have been extended a number of times before.

    The CMS is ending a moratorium on enrolling new Part B ground ambulance suppliers in several counties in Texas and Pennsylvania. Those providers can also now apply for Medicaid and Children's Health Insurance Plan reimbursement.

    An “evaluation has shown that the primary risk to the program comes from the non-emergency ambulance supplier category,” the agency says in a notice, adding that it had affected care issues for emergency ambulance services in some areas.

    Waivers to the moratorium allow for exceptions in areas where the ban would affect access to care.

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        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
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