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Medicaid Home Health Provider Enrollment Extended With Modifications Through January 29, 2021

Wednesday, July 29, 2020   (0 Comments)
Posted by: Kyle Simon

The Centers for Medicare & Medicaid Services (CMS) has extended the temporary moratorium on new home health agency (HHA) enrollments into the Florida Medicaid program through January 29, 2021, with some modifications.

The goal of the temporary moratorium is to fight fraud and safeguard taxpayer dollars while ensuring patient access to care. Authority to impose such moratoria was included in the Affordable Care Act.

Under the moratorium, existing HHAs can continue to deliver and bill for services. New HHA applications will be denied except under the following scenarios:

  • HHAs seeking to enroll as the result of a documented change of ownership of a Medicaid-enrolled HHA, as defined in section 408.803, Florida Statutes.
  • HHAs that meet all of the following criteria:
    • Are currently enrolled in Florida Medicaid at an existing service location;
    • Are applying for limited enrollment (limited enrollment allows for providers to participate in the network of managed care plans but not to bill Medicaid fee-for-service);
    • Are applying to serve one or more of Florida Medicaid Regions 1, 2, 3, 4, and/or 8;
    • Are a licensed HHA in good standing with the Agency for Health Care Administration (AHCA) licensure unit;
    • Have no outstanding debts to AHCA, whether licensure fees or fines, Medicaid overpayments, or any other monies owed to AHCA; and,
    • During the six-month period preceding the date the application is received by AHCA, served a minimum of 10 children (under 21) through their active Medicaid-enrolled HHA locations.

The moratorium does not affect the ability for HHAs to conduct business pursuant to the provisions of their license and applies only to participation as a Florida Medicaid provider.

For questions related to this alert or for assistance with provider enrollment, please call the Florida Medicaid Provider Enrollment Contact Center at (800) 289-7799 and select option 4.

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