Astralis
Consulting, Inc.
UNINTENDED CONSEQUENCES OF CMS's MORATORIUM
Although the map at the left shows only a small affected section of Illinois, it represents an under-served area of more than 80% of the state's total eligible Medicare and Medicaid health care to beneficiaries. Beginning July 30, 2013, CMS and Illinois officials will deny all new or pending applications for Medicare, Medicaid and CHIP enrollment from home health providers with practice locations in Cook, DuPage, Kane, Lake, McHenry and Will counties in Illinois.
Unfortunately a few bad operators have impacted many good and reputable people because of this type of heavy-handed regulatory bullying. Many new start-up agencies are now held-up from receiving legitimate payments rendered in anticipation of approval and some continue incur the overhead and staffing costs of providing free Medicare and Medicaid health care to beneficiaries.
We are working with our clients and CMS to correct this unfair restriction on new agency formation at the same time the moratorium has unintentionally doubled the value of all agencies in the affected areas of Chicago, Miami, and Huston.
Applications that have been received from these affected providers prior to the moratorium announcement will be denied and returned (along with fees, if applicable). Any provider that has already received an approval letter from the CMS contractor will not be affected.
The moratorium will be in place for six months and may be extended or lifted if circumstances warranting the moratorium continue or are resolved. CMS will publish a notice in the Federal Register if the moratorium is to be extended. During the moratorium, CMS will closely monitor home health billing for suspicious activity to root out fraud.
ILLINOIS
