Nevada’s Health Authority is pausing new state licenses for hospice and home-health providers and implementing a moratorium on new Medicaid enrollments until it can validate the legitimacy of current providers. The pause will remain in effect for at least six months following federal approval.
State officials said the action is necessary to address fraud in these programs. Ann Jensen, Nevada Medicaid Director, stated: “This temporary pause across state licensing and Medicaid is necessary to allow us time to get a handle on Medicaid billing fraud in Nevada for these important services.” Governor Joe Lombardo said: “Protecting taxpayer dollars and preserving access to quality healthcare services for Nevadans requires us to confront fraud head-on.”
This move follows a federal Centers for Medicare & Medicaid Services announcement of a similar nationwide six-month moratorium on new Medicare enrollment for hospices and home health agencies. Federal officials plan to “intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud.”
The moratoriums come after significant fraud cases uncovered in other states. A federal anti-fraud task force suspended approximately 800 hospices and home health agencies suspected of fraud across the Los Angeles area, which were responsible for $1.4 billion in Medicare spending last year with $70 million in suspended funds. California has revoked over 280 hospice licenses over the past two years, with 300 providers under investigation and 284 arrests.
During the six-month moratorium, Nevada state staff will conduct on-site reviews of all Medicaid-enrolled hospice and home-health providers. They will work with the Attorney General’s Office, federal partners, and law enforcement to investigate potential fraud. The Nevada Health Authority noted that to ensure access to critical services, some new providers may apply for an exemption if enrollment would improve access in rural and underserved communities.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.ktnv.com/news/nevada-pausing-licensing-for-state-hospice-home-health-providers