Law360 Article by Jaya White and Kiel Zillmer Explores Options for Home Infusion Providers Impacted by CMS Moratorium on New Enrollments
Jaya White and Kiel Zillmer, partners in the Quarles & Brady Health & Life Sciences Practice Group, wrote an article for Law360 about the unique challenges faced by the home infusion industry in the wake of a recent six-month moratorium by the Centers for Medicare & Medicaid Services (CMS) on the enrollment of new home health agencies (HHA).
Driven by a March executive order from the White House creating the Task Force to Eliminate Fraud, the May 13 HHA action by CMS follows a February six-month moratorium restricting the enrollment of certain durable medical equipment, prosthetics, orthotics and supply, or DMEPOS, companies, including medical supply companies with a registered pharmacist.
White and Zillmer explained that, for home infusion providers, the CMS moratoriums create added regulatory complexity that requires careful attention beyond what traditional HHAs must address.
An excerpt:
The issuance of the various moratoria has only made home infusion providers' compliance obligations more complex and ambiguous. Home infusion providers must now take into consideration the following to avoid potential enforcement actions, such as discipline by licensing authorities and reduced reimbursement, and other adverse outcomes and interruptions to business operations.
Carefully consider the intricacies of the moratoria in addition to all other potentially applicable laws and regulations and associated guidance, including specific enrollment requirements and limitations, and assess how they may apply to their business model and activities.
Be aware of any further announcements from regulators at the federal and state level regarding the current moratoria, such as extensions or modifications, and any potential future restrictions.
Remain vigilant with regard to keeping all licenses and enrollments current and in good standing, and promptly responding to all regulator inquiries and surveys to avoid an unintentional lapse or revocation that could necessitate the need for a new enrollment.
Please visit our Federal Policy Watch: Monitoring White House Developments page for more insight about navigating changes at the federal level.