The Centers for Medicare & Medicaid Services announced the six-month temporary suspension of enrollment of providers of hospice and home health agency services on Wednesday, in another administrative move to clamp down on fraud, waste and abuse.
The move will not affect enrollment of new patients for those services.
The nationwide moratorium on new Medicare enrollment of providers for hospices and home health agencies is intended to temporarily halt the influx of new providers into what are described as “high-risk categories,” also known as sources of fraudulent activity.
CMS Administrator Dr. Mehmet Oz said the move is about “protecting patients, restoring integrity and safeguarding taxpayer dollars.”
“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,” he said in a statement. “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.”
This enrollment hiatus is intended to stop improper billing and prevent fraudsters from entering the system, allowing for targeted prevention initiatives during the six-month pause. CMS said it will intensify investigations and accelerate the removal of hospice and home health agency providers suspected of committing fraud from the Medicare program.
New patients, current enrollments and existing providers will not be impacted by the moratoria, which can continue to deliver services to Medicare beneficiaries.
The move is in coordination with Vice President J.D. Vance’s Anti-Fraud Task Force, which launched in March to combat fraud in federal benefit programs and government contracts.
In a joint effort, CMS and the task force previously implemented a moratorium to prevent fraudulent Medicare billing by certain durable medical equipment, prosthetics, orthotics and supplies companies. In total, CMS now has three separate moratoria in place.
Recently, CMS suspended payments to 773 hospices and 23 home health agencies suspected of fraud in Los Angeles, representing $70 million in suspended funds. Dr. Oz has targeted a four-block area in the Van Nuys neighborhood of Los Angeles, where there are 42 hospices — what he calls the “epicenter for health care fraud in America.”
“So either there are a lot of people dying here, or you’ve got a fraudulent activity that is so good that everyone wants to get in on it,” he said in a January social media post.
His claim, unproven by the Justice Department, points to roughly $3.5 billion of fraud taking place in the city’s hospice and home care services, most of which is run by the Russian Armenian mafia.
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