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Feds ban some Medicare providers in crackdown

By The Associated Press

This article was published July 26, 2013 at 5:47 p.m.

MIAMI — For the first time in history, federal health officials said Friday they will ban certain types of Medicare and Medicaid providers in three high-fraud cities from enrolling in the taxpayer-funded programs for the poor as part of an effort to prevent scams.

The strict moratoriums, which start Tuesday, give federal health officials unprecedented power to choose any region and industry with high fraud activity and ban new Medicare and Medicaid providers from joining the programs for six months. They wouldn't ban existing providers.

The administrator of the Centers for Medicare and Medicaid Services said the agency is targeting providers of home health care in eight counties in the Miami and Chicago areas. All ambulance providers would be banned in eight counties in the Houston area.

"We fully support the action taken," said Val J. Halamandaris, president, National Association for Home Care & Hospice.

"NAHC has long supported program integrity measures such as this and strongly recommended that Congress give CMS the authority to issue a moratorium as part of the Affordable Care Act. We look forward to continue working with CMS as it considers other areas of the country where a moratorium may be needed," Halamandaris said.

The moratorium, which was first reported by The Associated Press, will also extend to Children's Health Insurance Program providers in the same areas, agency administrator Marilyn Tavenner said in a statement.

It's unclear how many providers will be shut out of the programs.

There were 662 home health agencies in Miami-Dade in 2012 and the ratio of home health agencies to Medicare beneficiaries was 1,960 percent greater in Miami Dade County than other counties, according to figures from federal health officials.

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