Frequently Asked Questions (FAQs) relating to licensing and the Centers for Medicare & Medicaid Services (CMS) Moratorium on Home Health Agency (HHA) Enrollment in Texas (Replaces PL 14-12)
The federal moratorium on enrollment of HHAs in the Medicare, Medicaid and Children’s Health Insurance Programs (CHIP), is expanded to include the entire state of Texas. The initial moratorium, first implemented on January 30, 2014 and extended through July 28, 2016, affected the enrollment of HHAs in certain counties located in the metropolitan areas of Dallas and Houston, Texas.
The statewide moratorium, effective July 29, 2016, applies only to initial licensed and certified home health agencies (L&CHHS) and does not affect the HCSSA categories of licensed home health (LHH), personal assistance services (PAS), or hospice. The current statewide moratorium period will last through December 28, 2016 and may be lifted or extended for subsequent six month periods. Further action will be announced by CMS in the Federal Register.
For more information about the moratorium (including the authority of CMS and the purpose and length of the moratorium) HCSSAs may refer to Survey and Certification (S&C) memorandum 16-36-HHA as well as the Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations published in the Federal Register Volume 81, Number 149, pages 51120 – 51124.
CMS also announced a demonstration project that will allow for “access to care-based exceptions” to the moratorium in certain limited circumstances. This will allow enrollment of an HHA after CMS determines that a beneficiary access-to-care issue exists and conducts an extensive heightened review of that provider. Information about the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Moratoria-Designated Geographic Locations, including how to submit a waiver application to CMS, is in the Federal Register Volume 81, Number 149, pages 51116 – 51120 and S&C 16-36-HHA.
Since the issuance of the moratorium, the Texas Department of Aging and Disability Services (DADS) has received a number of questions. The attached FAQ document addresses the CMS moratorium and its application to existing and newly licensed HCSSAs seeking Medicare certified locations.
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