Health Law Update

Home | Health Law Update

<img class="alignright wp-image-3713 size-medium" src="https://healthlawupdate.bakerhostetlerblogs.com/wp-content/uploads/sites/19/2016/08/hospital-iStock_53242650_XLARGE-181x300.jpg" alt="Paramedics carrying patient out of house on stretcher" width="181" height="300" />

The Centers for Medicare and Medicaid Services (CMS) recently <a href="https://www.bakerlaw.com/alerts/Ambulance%20and%20Home%20Health%20Moratorium%20Continued%20and%20Expanded">announced</a> an extension of its temporary moratorium on enrolling new nonemergency ambulance suppliers in New Jersey, Pennsylvania and Texas and new home health agencies in Florida, Illinois, Michigan and Texas for an additional six months. The agency also announced that the moratorium, which previously applied to specific metropolitan counties, will be expanded to all counties in the applicable states. The expansion is intended to prevent providers from enrolling in one county and providing services to beneficiaries in other counties. The moratorium affects new enrollments in Medicare Part B, Medicaid and the Children’s Health Insurance Program. Each temporary enrollment moratorium remains in effect for six months prior to reevaluation. The current moratorium has been effective for three years.

CMS also ended a temporary moratorium on enrolling new emergency ambulance services. However, providers should be aware that when a moratorium is lifted, the affected provider or supplier types will be subject to the agency’s high-screening level for a period of six months from the date the moratorium was lifted. New emergency ambulance suppliers that also furnish non-emergency services will be able to bill for only the emergency transport services.

In a separate <a class="js-autopdflink" href="https://www.gpo.gov/fdsys/pkg/FR-2016-08-03/pdf/2016-18381.pdf" target="_blank" rel="noopener">notice</a>, CMS announced the implementation of the Provider Enrollment Moratoria Access Waiver Demonstration (PEWD) which authorizes the agency to make exceptions to the state-wide enrollment moratoria in response to access-to-care issues. Enrollees with an approved PEWD application will be able to bill for services only in the designated geographic areas.

Ambulance and Home Health Moratorium Continued and Expanded