Home Health & Hospice Week

Any exceptions may be only on a county-by-county basis.

Home care providers that would like to begin serving Illinois, Texas, Florida, or Michigan may have slightly more hope of being able to open, instead of buy, a home health agency in those states.

The Centers for Medicare & Medicaid Services has announced it “is implementing revisions to the ‘The Provider Enrollment Moratoria Access Waiver Demonstration’ (PEWD),” according to the Medicare moratorium webpage.

Reminder: CMS began implement moratoria areas for new HHA enrollees in July 2013, then took the moratoria statewide in 2016. CMS announced the waiver in 2016 as well, but last year told Eli that no agency had successfully applied for one (see Eli’s HCW, Vol. XXVI, No. 30).

Under the revisions, “authorization of an exception would be based on beneficiary access to care or the new option requiring that the provider or supplier establish that it had submitted an enrollment application prior to implementation of the state-wide moratoria on July 29, 2016 that was denied as a result of implementation of such moratoria,” CMS explains on its website. HHAs “who meet either criteria will be subject to the heightened screening, oversight, and restrictions of the revised demonstration.”

Plus: “The demonstration includes a provision that may restrict the billing of newly enrolling providers to a specific county-based geographical area,” CMS says.

Essentially, “securing a waiver subjects the home health agency to a substantially increased level of scrutiny as evidenced by the information submitted with the waiver application,” notes The Health Group in Morgantown, West Virginia. “The information required to be submitted is consistent with certain proposed enrollment regulations that have never been finalized by CMS,” the consulting firm says in its electronic newsletter.

More information, including links to a fact sheet and the waiver application, are at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/ProviderEnrollmentMoratorium.html.