CMS announces 6-month enrollment pause for new hospice and home health providers
The Centers for Medicare & Medicaid Services announced Wednesday a six-month temporary suspension of registration for hospice providers and home health agencies, as part of another administrative action aimed at cracking down on fraud, waste and abuse.
This decision will not affect the registration of new patients for these services.
The national moratorium on new provider enrollment in Medicare for hospice and home health agencies is intended to temporarily stop the influx of new providers into what are described as “high-risk categories,” also known as sources of fraudulent activity.
CMS Administrator Dr. Mehmet Oz said the move was intended to “protect patients, restore integrity and protect taxpayer dollars.”
“We have witnessed systemic and deeply troubling fraud in home health care and home care, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” he said in a statement. “Today, we are closing the door on fraud, preventing new bad actors from accessing Medicare, while we aggressively identify, investigate and eliminate those who are already exploiting them. »
This registration pause is intended to stop inappropriate billing and prevent fraudsters from entering the system, allowing for targeted prevention initiatives during the six-month pause. CMS said it would intensify investigations and expedite removal from the Medicare program of hospice and home health agency providers suspected of committing fraud.
New patients, current enrollees, and existing providers will not be affected by the moratoriums, who can continue to provide services to Medicare beneficiaries.
The move is coordinated with Vice President J.D. Vance’s Anti-Fraud Task Force, launched in March to combat fraud in federal benefits programs and government contracts.
In a joint effort, CMS and the Task Force previously implemented a moratorium to prevent fraudulent Medicare billing by certain companies for medical equipment, prosthetics, orthotics, and durable supplies. In total, CMS has now implemented three separate moratoriums.
Recently, CMS suspended payments to 773 hospices and 23 home health agencies suspected of fraud in Los Angeles, representing $70 million in suspended funds. Dr. Oz targeted a four-block area in the Van Nuys neighborhood of Los Angeles, where 42 hospices are located — what he calls “the epicenter of health care fraud in America.”
“So either there are a lot of people dying here, or there is some fraudulent activity going on that is so good that everyone wants to participate in it,” he said in a January social media post.
His claim, unproven by the Justice Department, points to approximately $3.5 billion in fraud in the city’s hospice and home care services, most of which is run by the Russian Armenian mafia.
