By Tami Luhby, CNN
The Centers for Medicare and Medicaid Services announced Wednesday that it is placing a six-month moratorium on new enrollment of health providers in Medicare — its latest effort to combat what it says is widespread fraud among hospice and home health providers.
“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” CMS Administrator Dr. Mehmet Oz said in a statement.
“Today we’re shutting the door on fraud—preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them.”
Oz, who is working with Vice President JD Vance’s Anti-Fraud Task Force, has made combatting fraud a top priority. The two are set to make a fraud-related announcement on Wednesday afternoon.
Vance is also traveling to Maine on Thursday to discuss the administration’s anti-fraud efforts, which have targeted the state. President Donald Trump referenced Maine as a hotbed of fraud in his State of the Union address in February.
Maine’s Senate race, where GOP Sen. Susan Collins is running for a sixth term, is expected to be among the most competitive of the November midterm election.
In addition to pausing Medicaid payments to Minnesota earlier this year, Oz has filmed videos and sent letters to governors seeking information and demanding they craft plans to improve the integrity of their programs and revalidate providers.
In February, Oz sent a letter to Maine Gov. Janet Mills, a Democrat, citing concerns about the state’s Medicaid-funded treatment program for children with autism and demanding information about what the state is doing to identify and prevent fraud, as well as to recover stolen or misspent funds. Mills called the effort a “political attack.”
CMS also placed a similar six-month nationwide moratorium on certain companies that provide durable medical equipment, such as wheelchairs, hospital beds and oxygen equipment — an industry it says is also rife with fraud.
The administrator has focused his hospice anti-fraud efforts in the Los Angeles area. CMS says it has suspended $70 million payments to 773 hospices and 23 home health agencies suspected of fraud in the city.
CMS has also revoked or deactivated hundreds of hospices and home health agencies it says engaged in fraud or improper activity; increased oversight of new hospice providers in Arizona, California, Georgia, Ohio, Nevada and Texas; expanded reviews of home health agency claims in Florida, Illinois, Oklahoma, Ohio, North Carolina and Texas; and conducted hospice site visits.
However, the new moratorium could hurt legitimate providers of hospice services and limit patients’ access to care, the National Alliance for Care at Home said in a statement.
“An enrollment moratorium raises serious access-to-care concerns in areas where patient demand is growing or existing capacity is already strained, leading to longer wait times, reduced service availability, and fewer choices for patients – particularly in rural or underserved communities,” the alliance said.
The group added it and other national organizations have provided CMS with recommendations and targeted strategies for stopping bad actors from entering Medicare and Medicaid, while not overly burdening good-faith providers.
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