CMS Extends Existing Temporary Enrollment Moratoria by Six Months

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By James Swann  

July 29 — To fight fraud and abuse, the Centers for Medicare & Medicaid Services is extending temporary moratoria by six months for new home health agencies (HHAs) and ambulance suppliers attempting to enroll in Medicare in several metropolitan areas.

The CMS released a notice July 29 on the extension that is set for publication Aug. 1 in the Federal Register (79 Fed. Reg. 44, 702).

The HHA extensions apply to one county surrounding Fort Lauderdale, Fla., two counties surrounding Miami, six counties surrounding Chicago, five counties surrounding Detroit, seven counties surrounding Dallas and eight counties surrounding Houston. The ambulance supplier extensions apply to seven counties surrounding Philadelphia and eight counties surrounding Houston.

The notice of extension takes effect July 29.

Problem Not Yet `Abated.'

The CMS determined there was a need for the moratoria extensions after consulting with the Department of Justice and the Health and Human Services Office of Inspector General, which both said that the affected regions pose a risk of fraud, waste and abuse.

“The circumstances warranting the imposition of the moratoria have not yet abated, and CMS has determined that the moratoria are still needed as we monitor the indicators and continue with administrative actions such as payment suspensions and revocations of provider/supplier numbers,” the CMS notice said.

The temporary moratoria extension will not impact beneficiary access to services in the affected geographic regions, the CMS said, and the agency will re-evaluate the temporary moratoria at the end of the six-month extension period.

Moratoria Authority

Section 6401(a) of the Affordable Care Act authorized the HHS secretary to impose temporary moratoria on new Medicare enrollments of providers and suppliers if they pose a high risk of fraud, waste and abuse.

Moratoria can be based either on specific provider or supplier categories, specific geographic regions or a combination of the two.

The extension is the third time the temporary moratoria authority has been used. The initial temporary moratoria took effect in July 2013 and included newly enrolling HHAs in counties surrounding Miami and Chicago as well as newly enrolling ambulance suppliers in counties surrounding Houston.

The original temporary moratoria were extended by an additional six months early in 2014 (79 Fed. Reg. 6,475, Feb. 4, 2014), in addition to new temporary enrollment moratoria on HHAs operating in Fort Lauderdale, Fla., Dallas, Houston and Detroit, as well as ambulance suppliers in Philadelphia.

To contact the reporter on this story: James Swann in Washington at

To contact the editor responsible for this story: Ward Pimley at

The notice about the CMS extension is at

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