Home > CMS Updates, Florida, Fraud and Abuse, Health Law Reform -- General, Improving Healthcare, Medicare > CMS Leaves its Finger in the Dike by Extending its Temporary Moratoria on Enrollment

CMS Leaves its Finger in the Dike by Extending its Temporary Moratoria on Enrollment

On January 29, CMS announced last week that it would extend the “temporary moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse.”  The Federal Register will publish this announcement on February 2, 2015.

The ACA allows the HHS Secretary to impose a temporary moratorium on the enrollment of new Medicare, Medicaid or CHIP providers and suppliers to prevent (or combat) fraud, abuse, or waste.  The moratorium is for six months and can be extended in 6-month increments.

The war on healthcare fraud is a lot like fighting roaches in Florida.  You can be very vigilant, keep a clean house, and use pesticide regularly, but there will always be roaches — bigger and stronger ones to replace the ones you kill.  Likewise, we spend lots of money and devote significant resources to fighting healthcare fraud, and no matter how many fraud mongers we put out of business, there are always more to take their places.

The dike has to many leaks.  One wonders how much more legitimate healthcare could be given if so much wasn’t siphoned off by bad guys, but is there a practical solution?

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