CMS and OIG Increase Payment Suspensions Against Home Health Agencies
The Centers for Medicare & Medicaid Services and HHS Office of Inspector General are escalating enforcement actions against home healthcare providers suspected of fraud, including payment suspensions, recoupments, and criminal prosecution. Both Medicare and Medicaid suspensions are being deployed more frequently against home health agencies. The article outlines procedural steps for providers facing suspension. This enforcement trend affects Medicaid managed care organizations that contract with home health agencies and rely on them for post-acute and long-term services and supports delivery.
Heightened federal enforcement against home health agencies creates network stability and compliance risks for MCOs that rely on these providers for LTSS and post-acute care delivery.
LTSS · Managed Care
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