| The skinny
CMS implemented a six-month moratorium on new Medicare enrollment for hospices and home health agencies. The moratorium, issued Wednesday, seeks to temporarily stop the influx of new providers entering the hospice and home care space, which is emerging as a significant source of fraudulent activity. Cracking down across the country
The nationwide scope of the moratorium is designed to prevent bad actors from avoiding scrutiny by relocating to different states, CMS said. The federal government has launched strike forces and investigations into hospice fraud in several states, including California, Florida, Arizona and Nevada. Providers’ reaction
LeadingAge, an organization representing more than 5,000 senior care providers, said it supports the moratorium, arguing that stronger oversight is needed to eliminate fraud and protect patients. Another provider organization, the National Alliance for Care at Home, said it also supports CMS’ efforts to crack down on fraud in the hospice and home health sectors — but warned that a nationwide enrollment freeze could unintentionally limit patients’ access to care, particularly in rural and underserved areas where patient demand is rising or existing capacity is strained. The group argued that fraud is typically concentrated in specific regions and said CMS should pursue more targeted strategies to go after fraudulent providers. “CMS must use data-driven, risk-based program integrity measures and focus resources on boots-on-the-ground surveys and enforcement of existing oversight mechanisms that root out the blatantly bad actors without potentially limiting patient access to care or punishing high quality providers operating in good faith,” Jennifer Sheets, CEO of the National Alliance for Care at Home, said in a statement. — By Katie Adams |
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