Volume 26.03
Kim Brandt, Deputy Administrator and Chief Operating Officer of the Centers for Medicare & Medicaid Services (“CMS”), reported that the enrollment moratorium has prevented 250 home health agencies and 50 hospices from enrolling in Medicare since its announcement on May 13, 2026.
According to Ms. Brandt, “What we’ve been able to do, and what we’ll hopefully be able to show, is that thanks to the efforts we did there, we are now hopefully extending the life of the trust fund. And that’s why I think you saw the more favorable payment rates that you were able to see in this year’s rule.”
Although many home health and hospice providers remain unaffected, the moratorium has hindered many quality providers from opening offices within their existing service areas or expanding into adjacent areas, or both. The moratorium is an inappropriate tool for addressing fraud and abuse. CMS should instead focus on identifying problem providers and scrutinizing new enrollments more closely.
The moratorium is affecting access to care, particularly from quality providers. At the National Alliance for Care at Home’s Annual Meeting & Expo in Washington, D.C., Ms. Brandt acknowledged that although CMS does not intend to affect compliant providers, some will inevitably be caught in its program integrity net.
CMS’s efforts to root out abusive and fraudulent providers should not affect compliant providers.
Ms. Brandt stated that CMS is looking at exceptions to the moratorium for providers with quality compliance records. This approach is concerning because history indicates that implementation of such an exception program would bring problems regarding selection that could be potentially greater than those that currently exist.
It is our opinion that focusing on enrollment scrutiny is an appropriate and workable approach in combination with targeted claims reviews. CMS should remove the moratorium.
Ms. Brandt stated, “The one thing I will say about duration, we are statutorily required to do six months. We do not have the flexibility to say we’re only going to do it for two more months or three more months. If we do extend either or both, it has to be for a six-month period.” She also stated that CMS believes moratoria are necessary to sustain the Medicare program.
We expect the moratoria to continue beyond the current six-month period.
THANKS FOR VISITING WITH US AT ALLIANCE MEETING
We thank everyone who visited with us at the National Alliance for Care at Home’s Annual Meeting in Washington, D.C. If we missed you and you want to discuss cost reporting, Medicare enrollment, accounting and financial reporting, tax, or other issues of importance to you as year-end approaches, do not hesitate to contact us at contact@healthgroup.com.