The Texas Tribune
HOUSTON, Texas —The federal government has announced a six-month moratorium to halt enrollment of Houston-area ambulance service providers in Medicare, Medicaid and the Children’s Health Insurance Program in a bid to combat waste.
The moratorium, announced last week, marks the first use of a new law created by the Affordable Care Act that allows the Health and Human Services secretary to issue a moratorium to combat fraud, waste or abuse in Medicare or Medicaid. The department said in a statement that it issued the moratorium “based on data analysis and agency experience,” and cited six cases filed in Houston by the local U.S. attorney’s office since April 2012 that allege ambulance transport companies in the area submitted $9.5 million in fraudulent claims. Seven individuals were charged in connection to those cases, and so far, three have pleaded guilty and one was convicted by trial.
“CMS carefully examined Medicare beneficiary access to ground ambulance services in Houston and concluded that the moratorium will not affect access to care,” according to a statement released by the Centers for Medicare and Medicaid Services. “The agency also worked closely with the state Medicaid Agency in Texas to evaluate patient access to care, and the State determined that Medicaid and CHIP beneficiaries will continue to have access to services.”
Full story: Moratorium Targets Houston Ambulance Service Providers