联邦医保与医助服务中心延长全国临终关怀与家庭健康新注册冻结六个月，打击欺诈
美国联邦医保与医助服务中心（CMS）11月12日宣布，把全国范围内暂停临终关怀机构与家庭健康机构新注册加入联邦医保（Medicare）的冻结令再延长六个月，以保护受益人与纳税人资金免受欺诈、浪费与滥用。
CMS 局长 Mehmet Oz 说，过去六个月已取得切实进展，但临终关怀与家庭健康领域的欺诈依然存在，工作尚未完成，联邦医保受益人应得到保护，纳税人也需要确信他们依赖的计划没有被欺诈者掏空。
这项冻结最初于2026年5月13日开始，阻止可能从事欺诈的运营者进入并利用联邦医保。CMS 说，暂停期间该局开展有针对性的调查，并用先进数据分析识别涉嫌欺诈的临终关怀与家庭健康服务提供者，将其移出联邦医保计划。
与5月的冻结不同，本次延长允许已注册的临终关怀机构与家庭健康机构在现有注册内增设新的服务地点；延长不影响现有注册，也不妨碍已注册提供者继续提供服务。冻结继续覆盖首次注册的新申请与某些多数股权变更，并适用于全国，防止运营者跨州规避。
CMS 说，10月该局实地查访团队曾在加州针对家庭健康机构与临终关怀机构开展为期两天的行动，撤销了145家提供者的资格，涉及超过7.03亿美元的联邦医保与联邦医助付款。2027日历年家庭健康预付费体系最终规则还收紧了注册规则，包括撤销可追溯至违规之日、新增拒绝或撤销注册的情形等。
（来源：美国联邦医保与医助服务中心）
CMS Extends Nationwide Freeze on New Medicare Hospice and Home Health Enrollment for Six Months to Combat Fraud
The Centers for Medicare & Medicaid Services (CMS) announced on November 12 that it will extend its nationwide moratoria on new Medicare enrollments for hospices and home health agencies for an additional six months, to protect beneficiaries and taxpayer dollars from fraud, waste, and abuse.
CMS Administrator Dr. Mehmet Oz said real progress has been made over the past six months, but fraud in hospice and home health persists and the work is not finished, adding that Medicare beneficiaries deserve protection from bad actors and taxpayers need to know the programs they rely on are not being bled dry by fraudsters.
The initial moratoria began on May 13, 2026, preventing potentially fraudulent operators from entering and exploiting Medicare. CMS said the pause allows it to conduct targeted investigations and deploy advanced data analytics to identify hospice and home health providers suspected of fraud and remove them from the Medicare program.
Unlike the May 2026 moratoria, the extensions will allow currently enrolled hospices and home health agencies to add new practice locations within their existing enrollment. The extensions do not affect existing enrollments or prevent currently enrolled providers from continuing to deliver services. They continue to cover new applications for initial enrollment and certain changes in majority ownership, and apply nationwide.
CMS said that in October its site visit teams conducted a two-day operation targeting home health agencies and hospices in California that resulted in 145 revocations of providers associated with more than $703 million in Medicare and Medicaid payments. The Calendar Year 2027 Home Health Prospective Payment System Final Rule also tightened enrollment rules, including making revocations retroactive to the date of noncompliance and adding grounds for denial or revocation.
(Source: Centers for Medicare & Medicaid Services)
来源：美国联邦医保与医助服务中心
发布：GSM·美国（发布链接）
图片来源：图：美国卫生与公众服务部总部休伯特·汉弗莱大楼，联邦医保与医助服务中心隶属该部。ajay_suresh 摄，CC BY 2.0，经 Wikimedia Commons。 / Photo: The Hubert H. Humphrey Building, headquarters of the U.S. Department of Health and Human Services, which oversees CMS. Photo by ajay_suresh, CC BY 2.0, via Wikimedia Commons.
GSM Global · 本篇英文版 English edition of this story
