CMS Lifts Home Health Agency Moratorium On Medicare and Medicaid Enrollment
The affected states are Florida, Illinois, Michigan and Texas. Effective January 30, 2019, the moratorium is lifted for these states, meaning that new HHAs may now enroll in Medicare and Medicaid.
Temporary Enrollment Moratorium for HHAs Began in 2013
CMS halted HHA enrollments for the first time in 2013. The moratorium at that time covered certain counties near Chicago, IL and Miami, FL. Later, the moratorium was expanded to counties in Texas and Michigan and was subsequently broadened to include all counties in those four states.
The CMS enrollment moratorium had been extended every six months since then due to findings of fraud of these geographic areas, in addition to saturation of HHAs in those markets. CMS has the authority to issue a temporary moratorium to halt enrollments of new Medicare, Medicaid or CHIP providers in order to prevent fraud, waste or abuse.
States May Issue Their Own Enrollment Moratoriums
Although CMS may enforce a moratorium on the federal level, each state may limit HHA enrollment based on its own state licensing requirements. For example, New York has halted the licensing of Licensed Home Care Services Agencies for now. Therefore, because a facility must be licensed by the state and complete the Medicare certification process before enrolling in Medicare, state licensing requirements can limit HHA enrollment as well.
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If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.