The Nevada Health Authority announced Friday a temporary pause on new state licenses for hospice and home-health providers and a moratorium on new enrollments for Nevada Medicaid until state officials validate and confirm the legitimacy of current providers.
Upon federal approval, this moratorium will be in effect for at least six months.
Fraud in hospice and home-health services has garnered recent national attention with stories of high-dollar crimes from illegal Medicaid and Medicare billing activities and fake operations. In Nevada, the losses to Medicaid can be significant and nearly impossible to recover as many fraudulent providers are now diverting stolen payments to offshore accounts before the state can act. This demonstrates the urgent need for decisive action to protect the front door to the Medicaid program and prevent further losses of taxpayer dollars.
“Protecting taxpayer dollars and preserving access to quality healthcare services for Nevadans requires us to confront fraud head-on. Bad actors who use hospice and home-health programs as vehicles to steal public funds are undermining care for those who need it most,” said Governor Joe Lombardo. “I support the Nevada Health Authority’s decisive action to identify fraudulent providers, strengthen accountability, and work alongside law enforcement to pursue criminal prosecutions wherever wrongdoing is found. Nevada will not tolerate fraud, waste, or abuse in our public programs.”
In the interest of ensuring access to these critical services, Nevada Medicaid is allowing some new providers to apply for an exemption to this state moratorium if it will support improved access to hospice and home-health services in Nevada’s rural and underserved communities.
“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,” said Ann Jensen, Nevada Medicaid Director. “Without it, we will continue to lose out on the time needed to stop millions in scarce public resources from being stolen from bad actors who are posing as legitimate, licensed hospice and home health providers.”
Over the next six months, state staff will be conducting extensive onsite reviews of all Medicaid-enrolled hospice and home-health providers to identify any instances of potential Medicaid billing and payment fraud that require immediate attention and action. This includes working closely with the Office of the Nevada Attorney General, federal partners, and law enforcement to initiate criminal investigations.
