New York — The Trump administration said on Wednesday that it was working to expand its work Comprehensive anti-fraud initiative in federal health programs with a six-month nationwide freeze on any new Medicare enrollments by home health care agencies.
The moratorium will temporarily prevent all new providers in these categories from signing up for reimbursement from Medicare, and Federal insurance program for seniors across the country, the Centers for Medicare and Medicaid Services said in a news release.
“We have seen systematic and deeply troubling fraud in the hospice and home health industry, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from American taxpayers,” CMS Director Dr. Mehmet Oz said in a statement. “Today we are closing the door on fraud, preventing new bad actors from entering Medicare while aggressively identifying, investigating and removing those who are already exploiting them.”
This move is linked to the efforts of Vice President J.D. Vance Anti-Fraud Task Forcecreated by Republican President Donald Trump to eliminate potential misuse of public funds. It comes as people across the United States have raised concerns about rising health care costs and barriers to access, sometimes due to the actions of the federal government. For example, new Medicaid work requirements are expected to strain hospitals across the country and cause millions of enrollees to lose their health coverage.
Several alleged fraud schemes have been prosecuted in the home health and home health care categories, and states have acknowledged that they are a legitimate concern. But some have pushed back on the administration’s aggressive tactics and raised concerns that the sweeping effort could unnecessarily penalize law-abiding providers trying to serve patients.
The Administration asserts that this freeze and other actions it is taking will help prevent potential Medicaid and Medicare fraud and preserve funding and resources for the people who need it most. Under the six-month pause, existing home and health care providers will continue to operate as usual. But CMS said it would “intensify targeted investigations, deploy advanced data analytics, and accelerate the removal” of providers in the category suspected of fraudulent activity.
Such a freeze is not unprecedented, said Tricia Newman, senior vice president and executive director of the Medicare Policy Program at the health care research nonprofit KFF. The Democratic administration of President Bill Clinton also imposed a temporary moratorium on home health agencies, she said.
“The short moratorium gives the administration enough time to eliminate real fraud and prevent the emergence of new fraudulent entities,” she said.
In recent months, CMS suspended payments to hundreds of hospice and home care agencies in Los Angeles over alleged fraud and issued another six-month moratorium on suppliers of durable medical equipment, prosthetics, orthotics and certain other supplies in Medicare.
At least the administration came close Five states With investigations into potential health care fraud and withheld about $243 million in Medicaid payments to one of them, Minnesota, over fraud concerns. Last month, Oz announced that CMS would add to that oversight by requiring all 50 states to share how they planned to revalidate certain Medicaid providers.
In at least one case, the administration was wrong in its accusations against states. In April, CMS acknowledged this The Associated Press made a big mistake With the numbers I used to help justify the fraud investigation in New York. This admission deepened doubts about the administration’s methods and raised a common criticism about the second Trump administration — that it tends to attack first and assert facts later.