Health Care Law Blog

CMS Expands Temporary Home Health Agency Enrollment Moratorium to all of Michigan

The Centers for Medicare & Medicaid Services ("CMS") recently announced the statewide expansion of its temporary moratorium on the Medicare enrollment of new home health agencies ("HHAs"), subunits, and branch locations in Michigan.  As a result of the moratorium expansion, effective as of July 29, 2016, new HHAs in Michigan are precluded from enrolling in Medicare until the moratorium is lifted. The temporary moratorium also precludes the Medicare enrollment of new HHAs in Florida, Illinois, and Texas.  

The temporary moratorium on the Medicare enrollment of new HHAs previously applied only to Wayne County and surrounding counties in Michigan (the "Moratorium Area"). CMS determined that a high risk of fraud, waste and abuse existed outside of the Moratorium Area, due largely in part to providers "circumventing" the moratorium by enrolling a new practice location outside of the Moratorium Area and then serving beneficiaries within the Moratorium Area. As a result, CMS determined that it was necessary to expand the temporary moratorium to the entire state.

CMS guidance provides that the moratorium does not preclude an existing HHA from changing its practice location or from undergoing a change of ownership, unless the change of ownership requires an initial Medicare enrollment under the 36-month rule. An HHA should review any proposed enrollment changes with state officials.

The expanded moratorium will remain in effect for six months, and may be extended for additional six-month increments if CMS determines that an extension is necessary.

In addition to the moratorium expansion, CMS introduced the Provider Enrollment Moratoria Access Waiver Demonstration ("PEWD"). PEWD allows CMS to grant exceptions to the moratoria in certain limited circumstances if an access to care issue exists. Waivers will be granted on a case-by-case basis.

Please contact Jennifer Van Regenmorter or Julie Hamlet with any questions.

Categories: Medicare/Medicaid, Providers