Medicare Easing Prohibition for New Home Health Providers in Moratorium Areas

Medicare has eased a prohibition on new home health and non-emergency ambulance providers and will consider enrolling new providers on a case-by-case basis. Because of a temporary moratorium based on fraud and abuse concerns, new home health providers are currently barred from enrolling in Medicare in Florida, Illinois, Michigan, and Texas.

Providers looking for a waiver to the temporary moratorium will have to prove that their enrollment in Medicare is crucial to providing patients access to care as stated in the revision of a waiver demonstration from the Centers for Medicare & Medicaid Services (CMS). Specifically, “Approval of a waiver would be based primarily on either the provider or supplier demonstrating an access to care issue exists or that the provider or supplier submitted an enrollment application prior to implementation of a moratorium on July 29, 2016, or later that was denied as a result of implementation of such moratorium, and secondarily on passing the enhanced screening measures in the approved service area.”

The notice appeared in the Federal Register August 20, 2018. Contact Joy Cameron with any questions.

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