Medicare and Medicaid CMS expands fraud-fighting enrollment in six states

On July 29th, 2016, CMS announced they would extend and expand temporary fraud-fighting provider enrollment efforts in six states. A new demonstration project was also announced to permit certain exceptions to the moratoria and heightened screening requirements for new providers. CMS said that all current temporary moratoria was lifted for Medicare Part B, Medicaid, and CHIP emergency ground ambulance suppliers.

There is an extension for an additional six months for provider enrollment on new Medicare Part B non-emergency ground ambulance suppliers in New Jersey, Pennsylvania, and Texas, as well as home health agencies in Florida, Texas, Illinois, and Michigan. The statewide expansion also includes Medicaid and CHIP.

CMS also revealed the Provider Enrollment Moratoria Access Waiver Demonstration. This will give CMS the ability to allow a provider and supplier enrollment exceptions in the moratoria states if access to care issues are found and to help improve the methods of investigating and prosecuting fraud in Medicare, Medicaid, and CHIP.

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