CMS Announces First Home Health Agency Moratorium
July 29, 2013
The Chicago metro area has the dubious distinction of being the site of the first moratorium on Medicare provider enrollment for home health agencies. The Affordable Care Act (ACA) authorized CMS to institute moratoria to fight fraud in the Medicare, Medicaid and Children’s Health Insurance Program (CHIP).
The moratorium was announced in the Federal Register on July 26th and will begin on July 30, 2013. It applies to practice locations in Cook, DuPage, Kane, Lake, McHenry and Will Counties and will last for at least six months. CMS may extend the moratorium for subsequent six month periods by publishing additional notices in the Federal Register.
The moratorium will apply to enrollment in the Medicare, Medicaid and CHIP programs. Any new applications received will be denied, and pending applications will be denied and returned to the applicants. Any provider that has already received an approval letter from Palmetto may proceed with service delivery. Applicants with questions should contact Palmetto GBA at 1-866-830-3925.
The moratorium does not apply to changes in practice location for agencies already enrolled in Medicare, Medicaid or CHIP; to changes in provider or supplier information such as address or phone number; or to changes in ownership unless the new owner is required to undergo initial enrollment under 42 CFR 424.550 (the 36-month rule).
The Miami and Houston metro areas were also included in this moratoria.