On January 30, 2014, CMS announced a temporary moratorium on Medicare enrollment of home health agencies operating in Fort Lauderdale, Dallas, Houston, and Detroit.  It also announced a temporary moratorium on Medicare enrollment of ambulance suppliers in Philadelphia.  In addition, CMS announced a six-month extension of the current Medicare enrollment moratoria on home health agencies in Chicago and Miami and on ambulance services in Houston.  Existing providers and suppliers in these areas can continue to provide and bill for services, but no new provider and supplier Medicare enrollment applications will be approved during the moratoria. 

The Affordable Care Act grants CMS the authority to impose a temporary moratorium on the enrollment of new Medicare, Medicaid or CHIP providers and suppliers if it would be necessary to prevent or combat fraud, waste, or abuse.  The decision to implement enrollment moratoria is based on analysis of data, fraud trends, and consultation with law enforcement about geographic areas where fraud and abuse are prevalent.  The recent announcement, which took effect January 30, constitutes CMS’s second temporary Medicare enrollment moratoria.  The first moratoria took effect July 30, 2013.

In a CMS press release, CMS Administrator Marilyn Tavenner stated: “Our first use of the moratoria put fraudsters on notice that we are using all available tools, including these moratoria, to combat fraud, waste and abuse in our health care programs, while maintaining patients’ access to care.  Today’s announcement shows we are continuing our intense fight against fraud, waste and abuse in these vital health care programs.”

The press release is available here.  The announcement will be published in the February 4, 2014 Federal Register.  In the meantime, the pre-publication version of the announcement is available here.

Reporter, Jennifer S. Lewin, Atlanta, +1 404 572 3569, jlewin@kslaw.com