US freezes new Medicare enrollments for home care, hospice
The Trump administration will block new home healthcare and hospice suppliers from enrolling in Medicare for not less than the following six months, based on a authorities assertion posted as we speak, citing issues about widespread fraud.
The moratorium will briefly bar new suppliers in these classes from signing up for reimbursement from Medicare, a US authorities medical insurance program for Americans aged 65 and older and people with disabilities. It is not going to affect suppliers already registered with Medicare, based on the Centers for Medicare & Medicaid Services, which oversees this system.
It is the newest transfer by Vice President JD Vance’s anti-fraud job drive that goals to crack down on healthcare scams.
The US authorities has for years tried to deal with fraudulent funds from Medicare to hospice and home healthcare suppliers.
Scammers can invoice Medicare for providers that the affected person would not want or need, permitting them to rake in hundreds of thousands of {dollars} from the US authorities. The nationwide fraud prevention group Senior Medicare Patrol has repeatedly issued alerts on the problem.
It is uncommon to pause registrations nationwide. CMS has paused enrollments up to now in particular counties when workers suspected fraud tied to these areas, together with in 2013, when it barred new suppliers primarily based in Florida’s Miami-Dade County and several other counties in Illinois.
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CMS Administrator Mehmet Oz didn’t present particular proof to reporters as we speak to clarify why the Trump administration believes it’s essential to bar new enrollments throughout the US, versus in particular areas.
Fraudsters who’ve been barred from gathering Medicare funds typically attempt to get across the ban by beginning a new firm and registering for funds, stated Stephen Lee, a former federal prosecutor who labored in Illinois on the time of the 2013 enrollment pause.
But pausing new enrollments would not assist alleviate theft by firms which are already enrolled in Medicare, he stated. “It would be a mistake to think that this tool alone will work.”
Reuters was first to report on the pause. The moratorium will give CMS time to account for hospice and home well being expenditures underneath the Medicare program and create extra steering, an administration official stated.
The Trump administration has been criticized for mixing the president’s political preferences with company efforts to get rid of fraud in authorities funds. The administration singled out some Democratic-led states, together with California and Minnesota, as not doing sufficient to fight fraud.
Vance as we speak stated the Trump administration would defer $1.3 billion in funding for California to detect and stop Medicaid fraud. Medicaid is the federal- and state-run well being program for low-income Americans.
In 2024, 1.8 million Medicare beneficiaries acquired hospice care at a value of $28.3 billion, based on the Medicare Payment Advisory Commission. The similar yr, 2.7 million sufferers on Medicare acquired home healthcare at a value of $16 billion, based on the company that advises Congress on healthcare spending.
Vance’s job drive has not too long ago taken motion towards hospice providers, significantly in California, the place the state auditor stated in 2022 that lax oversight had enabled large-scale fraud.
Industry teams had urged totally different approaches because the Trump administration weighed potential motion.
The National Partnership for Healthcare and Hospice Innovation stated in March it supported briefly pausing hospice supplier enrollments. The National Alliance for Care at Home warned towards overly broad motion that might deter docs and sufferers from recommending or searching for care.
Major home well being operators within the US embody BrightSpring Health Services, non-public equity-backed Matrix Medical Network, and UnitedHealth Group. Chemed Corporation subsidiary VITAS Healthcare is among the many prime hospice care suppliers.
Tens of billions of {dollars} are estimated to be misplaced within the United States by healthcare fraud annually, translating into increased prices for sufferers and employers, based on the National Health Care Anti-Fraud Association.
The administration of US President Donald Trump has additionally sought to deal with different healthcare sectors it has deemed a fraud danger. The administration in February paused Medicare enrollments by suppliers of sturdy medical tools, comparable to prostheses.
The fraud crackdown began in Minnesota, the place the Trump administration stated in February it will withhold $259 million in funds for Medicaid.
Trump has repeatedly invoked a scandal in Minnesota that dates again to 2020, during which 47 folks have been accused of defrauding $250 million from a state-run, federally funded youngster diet program. Many of the defendants in that case have been Somali Americans, based on native information studies.
The controversy prompted Trump earlier this yr to ship in hundreds of federal immigration officers as a part of a migrant crackdown. He shifted techniques to a much less aggressive method after federal officers shot lifeless two folks protesting his insurance policies.
In asserting the fraud job drive in March, Trump, with out offering proof, stated fraud allegations have been increased in Democratic-led states than in Republican-led states.
