cms has extended a pause on new Medicare enrollments for hospice and home health agencies by six months. The Centers for Medicare & Medicaid Services announced the decision Thursday as part of an ongoing effort to combat fraud, waste, and abuse within the program. The agency stated that the circumstances justifying the moratorium have not yet abated, necessitating a continued pause on new applications.
The original moratorium, issued earlier this year, was designed to give the agency time to conduct targeted investigations and deploy advanced data analytics. CMS noted that hospice and home health providers have historically been high-risk areas for fraud.
The extension applies nationwide. However, providers that are already enrolled in Medicare will not be impacted. These agencies can continue to offer services to beneficiaries and can add new practice locations to their existing enrollment.
CMS has suspended payments to 773 hospice providers and 23 home health agencies in the Los Angeles area. These suspensions cover approximately $70 million in funds. The agency is also conducting site visits across the country and has expanded a demonstration in several states to review submissions before payments are made.
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The National Alliance for Care at Home responded to the announcement by welcoming the scrutiny. The group noted that providers will still be able to conduct face-to-face recertification visits via telehealth during the enrollment pause. This allowance aims to help avoid unnecessary care disruptions for patients and families.
Despite these protections, the alliance expressed concern over access to care in high-demand areas. The organization urged CMS to focus its enforcement on high-fraud markets or specific bad actors rather than catching the rest of the sector in the net. The group emphasized that the agency should prioritize boots-on-the-ground surveys and the enforcement of existing oversight mechanisms.
CMS Administrator Mehmet Oz, M.D., stated that Medicare beneficiaries deserve protection from bad actors and that American taxpayers need to know the programs they rely on are not being bled dry by fraudsters. The agency has taken similar steps this year, including a moratorium on durable medical equipment, prosthetics, orthotics, and supplies companies.
PUBLISHED: May 13 at 11:30 a.m.
