Home Health & Hospice Week

Which cities might be next?

If you were planning on expanding to certain high-volume, high-fraud-suspicion areas, it’ll have to be through acquisitions.

The Centers for Medicare & Medicaid Services has extended the moratoria on new home health agencies and home health subunits another six months in six cities in four states, it says in the July 28 Federal Register. CMS first implemented the moratoria in July 2013 in Miami-Dade and Chicago (see Eli’s HCW, Vol. XXII, No. 27), two years after the moratorium authority was enacted. Then in February 2014, it added Ft. Lauderdale, Detroit, Dallas, and Houston (see Eli’s HCW, Vol. XXIII, No. 6).

CMS consulted with the HHS Office of Inspector General, and the “OIG agrees that a significant potential for fraud, waste, and abuse continues to exist in these geographic areas,” CMS says in the Federal Register notice. “The circumstances warranting the imposition of the moratoria have not yet abated, and CMS has determined that the moratoria are still needed as we monitor the indicators and continue with administrative actions, such as payment suspensions and revocations of provider/ supplier numbers.”

More cities ahead? Since most of the current moratoria areas also have HEAT Medicare Fraud Strike Force teams operating in them, don’t be surprised if a third wave of HHA moratoria announcements include the last four Strike Force cities — Baton Rouge, La., Brooklyn, N.Y., Los Angeles, and Tampa Bay, Fla., experts say. See exactly which counties are affected in the notice at www.gpo.gov/fdsys/pkg/FR-2015-07-28/pdf/2015-18327.pdf.