The home Health moratoria went into effect in 2013 in Chicago, Illinois, and Miami, Florida, to prevent the enrollment of new agencies in these areas and has since expanded to other regions. The moratoria aims to prevent and combat fraud, waste and abuse, according to CMS.
In addition to home health agencies, the moratoria impacts Medicare Part B non-emergency ground ambulance providers and suppliers.
The moratoria has continually been extended in six-month periods since 2013. To determine which regions would be subjected to the moratorium, CMS relied on law enforcement reports with ongoing and emerging fraud trends and activities through civil, criminal and administrative investigations and prosecutions.
CMS also analyzed its own data to identify specific provider and supplier types within geographic locations with potential for fraud, waste or abuse. And the agency consulted with the Department of Health and Human Services (HHS) Office of Inspector General (OIG).
Industry associations have criticized broad actions by CMS in the past when it comes to combatting fraud. However, they have largely been supportive of the moratoria. Other experts have criticized the moratoria, arguing it has done little to prevent fraud, abuse and waste.
Written by Amy Baxter