Pause of new hospice facilities, home-care providers, takes effect in Nevada

A moratorium on new licensing and Nevada Medicaid enrollment for most prospective hospice facilities and home health providers has taken effect.

The six-month pause — backed by Gov. Joe Lombardo — was designed to give the state time to investigate possible fraud, according to officials.

It went into effect on June 11, a few days after Nevada announced the proposal and about a month after the U.S. Centers for Medicare and Medicaid Services implemented its own moratorium on enrollments for hospice and home health providers.

The restriction does not apply to revalidations, changes of ownership or updates to existing enrollments, the Nevada Health Authority said in its latest announcement.

The agency previously said that new providers who would benefit rural and underserved communities could apply for a waiver.

“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,” Nevada officials said earlier this month. “This includes working closely with the Office of the Nevada Attorney General, federal partners, and law enforcement to initiate criminal investigations.”

It was unclear this week if those probes have begun or how they’re playing out. A Nevada Health Authority spokesperson said this week that the agency can’t comment on details regarding investigations.

More than 300 hospice providers in Clark County

Karen Rubel, Nathan Adelson Hospice president and CEO, told the Las Vegas Review-Journal Monday that there were already more than 300 hospice providers in Clark County.

Providers need licenses to operate and secure billing access with Nevada Medicaid, she noted.

Rubel said that she supports the moratorium, calling the six-month period a good start. As of Monday, she hadn’t received any updates from Nevada.

“I don’t know what the scope of their investigation is going to be or what they’re looking for,” Rubel said. “I think they probably have a good idea.”

Lombardo had touted the moratorium proposal as a way to protect tax dollars and preserve access to quality healthcare.

“Bad actors who use hospice and home-health programs as vehicles to steal public funds are undermining care for those who need it the most,” he said in a statement.

Attorney General Aaron Ford’s office did not respond to a message asking if it’s been brought into the investigative process. Ford, a Democrat, is running to replace Lombardo, a Republican.

Through his campaign, Ford had criticized the proposal as a “despicable ploy of taking away dying Nevadans’ health care to appease (President) Donald Trump.”

He said Nevada already investigates Medicaid fraud, and that his office had secured dozens of convictions related to it, recovering about $41 million.

Lombardo’s re-election campaign disputed the motivation claim.

“The reality is that no Nevadan will lose their healthcare,” it said on X. “This is just another attempt to manufacture a political talking point.”

Moratorium follows complaints

The moratorium is similar to one instituted by California a few years ago when there was an explosion of new hospice facilities, prompting the state to pause licensing, Rubel noted.

She said that a similar trend began to emerge in Nevada.

Nathan Adelson Hospice, a nonprofit provider that operates multiple facilities, started hearing from loved ones of patients seeking relocation in Southern Nevada, Rubel said.

“We started tracking those calls, and we found that people were not seeing a nurse, they weren’t getting medication, they weren’t getting their durable medical equipment, they were being redirected to the emergency room if there was something happening with the patient overnight because staff couldn’t get there,” Rubel said.

While Nathan Adelson Hospice welcomes competition, the calls were concerning and becoming more frequent, she said.

Rubel said that moratorium shouldn’t limit hospice care due to the number of providers already operating.

“I think that it’ll give the state some time to wrap their arms around the issue, to kind of really see what’s going on, especially in Clark County, where you have so many hospices that have opened up,” she said.