The Centers for Medicare and Medicaid Services introduced Wednesday that it’s putting a six-month moratorium on new enrollment of health suppliers in Medicare — its newest effort to fight what it says is widespread fraud amongst hospice and home health suppliers.
“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” CMS Administrator Dr. Mehmet Oz mentioned in an announcement.
“Today we’re shutting the door on fraud—preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them.”
Oz, who’s working with Vice President JD Vance’s Anti-Fraud Task Force, has made combatting fraud a prime precedence. The two are set to make a fraud-related announcement on Wednesday afternoon.
Vance can also be touring to Maine on Thursday to debate the administration’s anti-fraud efforts, which have focused the state. President Donald Trump referenced Maine as a hotbed of fraud in his State of the Union handle in February.
Maine’s Senate race, the place GOP Sen. Susan Collins is working for a sixth time period, is anticipated to be among the many best of the November midterm election.
In addition to pausing Medicaid payments to Minnesota earlier this yr, Oz has filmed movies and despatched letters to governors searching for data and demanding they craft plans to enhance the integrity of their applications and revalidate suppliers.
In February, Oz despatched a letter to Maine Gov. Janet Mills, a Democrat, citing considerations in regards to the state’s Medicaid-funded therapy program for kids with autism and demanding details about what the state is doing to determine and stop fraud, in addition to to get better stolen or misspent funds. Mills referred to as the trouble a “political attack.”
CMS additionally positioned an analogous six-month nationwide moratorium on sure corporations that present sturdy medical gear, akin to wheelchairs, hospital beds and oxygen gear — an business it says can also be rife with fraud.
The administrator has centered his hospice anti-fraud efforts in the Los Angeles space. CMS says it has suspended $70 million funds to 773 hospices and 23 home health companies suspected of fraud in town.
CMS has additionally revoked or deactivated a whole lot of hospices and home health companies it says engaged in fraud or improper exercise; elevated oversight of new hospice suppliers in Arizona, California, Georgia, Ohio, Nevada and Texas; expanded evaluations of home health company claims in Florida, Illinois, Oklahoma, Ohio, North Carolina and Texas; and performed hospice web site visits.
However, the new moratorium may harm legit suppliers of hospice companies and restrict sufferers’ entry to care, the National Alliance for Care at Home mentioned in an announcement.
“An enrollment moratorium raises serious access-to-care concerns in areas where patient demand is growing or existing capacity is already strained, leading to longer wait times, reduced service availability, and fewer choices for patients – particularly in rural or underserved communities,” the alliance mentioned.
The group added it and different nationwide organizations have offered CMS with suggestions and focused methods for stopping dangerous actors from coming into Medicare and Medicaid, whereas not overly burdening good-faith suppliers.