As with previous extensions of the moratorium, CMS, in coordination with the Department of Health and Human Services Office of Inspector General, has found that the circumstances warranting the imposition of the moratoria have not yet abated. Existing providers and suppliers can continue to deliver and bill for services, but no new provider and supplier applications will be approved in the South Florida counties of Broward (Fr. Lauderdale), Miami-Dade, and Monroe; metro-Chicago counties of Cook, DuPage, Kane, Lake, McHenry, and Will; metro- Detroit counties of Macomb, Monroe, Oakland, Washtenaw, and Wayne; metro-Dallas counties of Collin, Dallas, Denton, Ellis, Kaufman, Rockwall, and Tarrant; and metro-Houston counties of Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery, and Waller.
The initial six month moratorium took effect July 30,2013 and has been extended in six-month increments ever since. The last extension took effect on February 2, 2015. The moratoria only apply to new applicants for home health. They do not affect hospice applicationsif an agency’s 855A has been submitted and accepted by the Fiscal Intermediary, it may still be included in the moratorium. Only Medicare Administrative Contractors can inform applicants of their status.
CMS consulted with the HHS Office of Inspector General and the Department of Justice to determine that fraud and extremely high utilization both trend upward in areas where there is a disproportionate number of providers relative to the number of beneficiaries. All the geographic areas named in the moratoria ranked high in these fraud risk factors.
©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. email@example.com