CMS Imposes 6-Month Nationwide Moratorium on Home Health Agency Enrollment
CMS has announced a 6-month nationwide moratorium on the enrollment of new home health agencies in Medicare. The moratorium applies to Medicare enrollment only and does not directly affect existing Medicaid managed care network contracts with currently enrolled HHAs. The action is typically taken to address fraud and abuse concerns in the home health sector. Medicaid MCOs should monitor whether states implement parallel enrollment restrictions and assess potential network adequacy implications if the moratorium affects HHA availability in their service areas.
The Medicare enrollment freeze may reduce HHA capacity in markets where Medicaid MCOs rely on Medicare-certified agencies for LTSS and home health services, potentially affecting network adequacy and care coordination for dual-eligible members.
LTSS · Managed Care
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