CMS Issues Nationwide Six-Month Moratorium on Hospice and Home Health Medicare Enrollments: What Providers Need to Know

PRESS RELEASE

Published: May 13, 2026

The healthcare industry was shaken on May 13, 2026, when the Centers for Medicare & Medicaid Services (CMS) announced one of the most sweeping enrollment actions in recent memory — a simultaneous, nationwide six-month freeze on new Medicare enrollments for both hospice providers and home health agencies (HHAs). For organizations operating in the post-acute care space, understanding the full scope, rationale, and practical implications of this moratorium is not optional — it is essential.

This article breaks down everything currently known about the moratorium: who it affects, why CMS took this step, what exceptions exist, how it impacts ownership changes and transactions, and what providers and accreditation bodies like CHAP can do right now.

What Exactly Did CMS Announce?

On May 13, 2026, CMS published two companion notices in the Federal Register — one covering home health agencies (Document No. 2026-09717) and one covering hospices (Document No. 2026-09718). Both notices imposed immediate, nationwide, six-month temporary moratoria on Medicare enrollment for new providers in these sectors.

The action is directly tied to Vice President JD Vance's Anti-Fraud Task Force and represents the Trump Administration's continuing push to eliminate fraud, waste, and abuse from the Medicare program. It follows a similar moratorium imposed in February 2026 on certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) providers — signaling that this is not an isolated action, but part of a deliberate and escalating enforcement strategy.

The moratorium applies uniformly across all 50 states, the District of Columbia, and all U.S. territories, making it far broader in scope than prior targeted geographic moratoria that had focused on specific high-risk states or metro areas.

Who Is Affected?

The moratorium prohibits CMS from processing any new Medicare enrollment application from:

- New hospices or hospice practice locations

- New home health agencies, including HHA branch offices and practice locations

Critically, existing enrolled providers are not affected. Organizations currently enrolled in Medicare may continue operating, delivering services to beneficiaries, and submitting claims without interruption — provided they do not trigger a new enrollment requirement through certain ownership changes (discussed in detail below).

The moratorium also blocks providers undergoing a non-exempt change in majority ownership (CIMO) within 36 months of their initial enrollment or their most recent CIMO. Under the Medicare "36-month rule," such transactions require the entity to enroll as a brand-new provider — meaning the moratorium effectively prevents these transactions from proceeding until the freeze is lifted.

The Fraud Problem: Why CMS Acted Now

To appreciate the urgency behind this action, it helps to understand just how significant the fraud problem has become in both the hospice and home health sectors.

The Hospice Fraud Crisis

The HHS Office of Inspector General (OIG) has documented a pattern of troubling practices in the hospice industry that has grown substantially worse over the past seven years. The problems identified include:

Enrollment of ineligible patients: Certain hospices were found to have certified patients who did not meet the clinical criteria for terminal illness — and in some instances, those patients were incorrectly informed that they were dying. Patients improperly enrolled in hospice are simultaneously at risk of losing access to curative treatments, since the hospice benefit typically requires forgoing such care.

Explosion in questionable providers: CMS documented a sharp rise in the number of hospice providers exhibiting red flags, particularly concentrated in states like Arizona, California, Nevada, and Texas. Some of these newly enrolled hospices listed addresses that appeared to be non-functional or fictitious.

"Churn and burn" fraud schemes: In these schemes, a hospice opens and begins billing Medicare. Once it faces an audit or hits a payment threshold, it shuts down — operators pocket the funds, obtain a new Medicare billing number, transfer patients to the new entity, and restart the billing cycle. These schemes are notoriously difficult to address through traditional post-enrollment review.

Illegal recruitment and kickback arrangements: Some bad actors paid recruiters to enroll beneficiaries who didn't qualify for hospice services, sometimes without those beneficiaries' knowledge or consent. Others paid kickbacks to physicians willing to falsely certify a patient's terminal status.

Profit-driven formation: In some documented cases, hospices were established primarily to be sold at a profit or to avoid revocation after fraudulent activity had already been detected — with patient care as an afterthought rather than a priority.

CMS argued that these patterns have elevated hospice fraud to a level of program integrity risk comparable to home health agencies and DMEPOS suppliers — sectors long considered among the highest-risk in Medicare. Given this, a moratorium targeting only post-enrollment review or owner screening was deemed insufficient. Preventing fraudulent actors from entering the program in the first place is seen as a fundamentally stronger safeguard than the traditional "pay and chase" enforcement model.

The Home Health Fraud Problem

Home health fraud is not a new issue — it has been documented for over two decades. The inherent structure of home-based care, with relatively low startup costs and limited direct supervision of service delivery, creates an environment where fraud can flourish.

CMS cited specific and alarming data points to justify the home health moratorium:

- A dramatic increase of more than 40% in new HHA enrollments in Los Angeles County alone between 2019 and 2023

- Clusters of multiple HHAs operating from single shared addresses in states like Ohio — a classic indicator of shell entity fraud

- Numerous criminal convictions involving home health fraud across the country

The OIG noted as far back as 2018 that home health has long been recognized as one of the most vulnerable program areas in Medicare. Despite numerous CMS enforcement initiatives over the years — enhanced screening, payment safeguards, and targeted moratoria in high-risk areas — HHA program integrity risks remain among the highest of any provider type in the program. CMS concluded that while prior actions may have blunted the problem, they did not resolve it, and a more decisive nationwide intervention was warranted.

Key Exceptions and What Is NOT Affected

The moratorium is broad, but it does not apply universally. Understanding the exceptions is critical for providers navigating this period.

The following actions are not blocked by the moratorium:

- Changes in practice location — provided the new location is not moving from outside the moratorium area to inside it (which, given the nationwide scope, is essentially a non-issue here)

- Changes in provider or supplier information — such as updating phone numbers, addresses, or other administrative details

- Certain changes in ownership — specifically those that do not require a new initial enrollment under CMS rules

- Enrollment applications already received by a Medicare Administrative Contractor (MAC) before May 13, 2026 — these are grandfathered and will continue to be processed

This last point is particularly important: any provider that had submitted an enrollment application to its MAC prior to the effective date should immediately gather and preserve documentation proving the submission date, as this will be the basis for claiming the grandfathering exemption.

Impact on Mergers, Acquisitions, and Ownership Transitions

The moratorium has created significant turbulence in the M&A landscape for hospice and home health. Any transaction that would require a new Medicare enrollment — including asset purchases, changes of majority ownership that trigger the 36-month rule, or corporate restructurings resulting in a new provider number — is effectively on hold until the moratorium is lifted or expires.

Legal and compliance teams advising on these transactions must carefully evaluate:

- Whether a contemplated deal structure would trigger CIMO classification under the 36-month rule

- Whether the existing enrollment and provider agreement would be terminated as a result

- Whether deal timelines need to be extended to account for potential moratorium extensions beyond the initial six months

- How purchase agreements should be amended to address moratorium risk through representations, warranties, and closing conditions

Not all ownership changes are blocked. Equity transactions that do not alter the provider's legal entity or cross the CIMO threshold — sometimes called "change of information" (COI) transactions — can still proceed and may allow Medicare billing to continue uninterrupted. However, each situation requires careful, individualized legal analysis.

How Long Will This Last — and Can It Be Extended?

The initial moratorium period runs six months from May 13, 2026. However, CMS has explicit regulatory authority under 42 C.F.R. § 424.570(b) to extend the moratorium in successive six-month increments if it determines that the conditions giving rise to the freeze remain unresolved.

Stakeholders should plan for the real possibility that the moratorium extends beyond November 2026. The February 2026 DMEPOS moratorium — the predecessor to this action — suggests that CMS is prepared to sustain these interventions if fraud concerns persist.

CMS may lift a moratorium early if any of the following circumstances arise:

- A Presidential disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act

- A determination that the circumstances warranting the moratorium have abated or that program safeguards have addressed the vulnerability

- A Secretary-declared public health emergency

- A judgment by the Secretary that the moratorium is no longer needed

If and when the moratorium is lifted, providers that were blocked from enrolling will be assigned to the "high" screening level for a period of six months following the lifting, subjecting them to enhanced scrutiny in the enrollment process.

What CMS Plans to Do During the Moratorium

CMS is not simply freezing enrollments and waiting. During the six-month window, the agency has outlined an active enforcement agenda:

- Intensified targeted investigations into suspected fraudulent hospice and HHA operators

- Advanced data analytics deployment to identify billing irregularities and unusual patterns

- Accelerated removal of hospice and HHA providers suspected of fraud from the Medicare program

- Heightened oversight of newly enrolled hospices in states identified as elevated fraud risks — specifically Arizona, California, Georgia, Nevada, Ohio, and Texas

- A new publicly available hospice scoring system to increase transparency and flag providers with troubling utilization, quality, or compliance patterns

- Enhanced enrollment screening for high-risk HHAs, including physical site verification of reported practice locations and fingerprint-based background checks

- An expanded pre- and post-payment review demonstration for HHA claims in Florida, Illinois, Oklahoma, Ohio, North Carolina, and Texas

Implications for Medicaid and CHIP

The CMS moratorium applies directly only to Medicare enrollment. However, CMS has strongly encouraged every state to consider implementing parallel moratoria for their Medicaid and CHIP programs, tailored to state-specific beneficiary populations and geographic risk factors.

CMS has indicated it is available to consult with any state or territory evaluating whether to adopt a comparable Medicaid-side moratorium. Healthcare organizations with dual Medicare-Medicaid operations should monitor their states closely, as the regulatory environment across Medicaid programs may shift substantially in the coming months.

What This Means for Existing Accredited Providers

It bears emphasizing: the moratorium does not affect currently enrolled and accredited providers. Organizations that have earned and maintained Medicare enrollment — including those accredited through recognized accrediting bodies — may continue providing services to Medicare and Medicaid beneficiaries without interruption.

For these providers, the moratorium period may present a strategic opportunity. With fraudulent and marginal operators unable to enter the market, providers with a demonstrated commitment to quality care, strong compliance programs, and recognized accreditation are positioned to distinguish themselves in an increasingly scrutinized industry.

Accreditation through organizations like CHAP continues to serve as a meaningful signal of quality and compliance — and in an environment where CMS is deploying new scoring systems and transparency tools, that differentiation matters more than ever.

What Providers Should Do Right Now

Whether you are an existing provider, a prospective new entrant, or an organization involved in a pending transaction, there are concrete steps to take immediately:

1. Verify your enrollment status — Confirm that your Medicare enrollment information is current and accurate, including all practice locations and ownership information.

2. Preserve pre-May 13 application documentation — If you submitted an enrollment application before the effective date, gather proof of submission immediately. This is your key to the grandfathering exemption.

3. Pause or restructure pending transactions — If you have a deal in progress that would trigger a new Medicare enrollment, engage legal counsel immediately to assess your options and exposure.

4. Monitor state Medicaid developments — Track your state's response to CMS's encouragement to adopt parallel Medicaid moratoria.

5. Engage with compliance resources — This is an excellent time to review your organization's compliance program, documentation practices, and billing integrity. Enhanced CMS scrutiny will apply even to existing providers during this period.

6. Attend industry briefings — Organizations like CHAP have been hosting webinars to help providers understand the operational and accreditation implications of the moratorium. Taking advantage of these resources ensures your leadership team is working from accurate and current information.

Looking Ahead

The May 13, 2026 moratorium represents a meaningful inflection point for the hospice and home health industries. It is the most aggressive nationwide enrollment action CMS has taken against these provider types, and it signals that the era of relatively easy program entry — regardless of intent — is over.

For legitimate providers focused on quality patient care, the disruption is real but manageable. For the industry as a whole, this moment may ultimately accelerate a long-needed shift toward greater transparency, stronger compliance cultures, and higher barriers to entry that protect both beneficiaries and taxpayers.

CMS has made clear that it intends to use this six-month window not merely as a pause, but as an active enforcement period. The providers who emerge from this period in the strongest position will be those who treated the moratorium not as a threat, but as a call to demonstrate why they deserve their place in the Medicare program.

References and Additional Resources

- [CMS Press Release – CMS Announces Aggressive Nationwide Crackdown on Fraud with Six-Month Hospice and Home Health Agency Enrollment Moratoria](https://www.cms.gov/newsroom/press-releases/cms-announces-aggressive-nationwide-crackdown-fraud-six-month-hospice-home-health-agency-enrollment)

- [Federal Register – Home Health Moratorium (Doc. No. 2026-09717)](https://www.federalregister.gov/d/2026-09717)

- [Federal Register – Hospice Moratorium (Doc. No. 2026-09718)](https://www.federalregister.gov/d/2026-09718)

- [CMS Home Health and Hospice Nationwide Moratorium Q&As](https://www.cms.gov)

- [CHAP – Hospice and Home Health Moratoria Resource Page](https://www.chapinc.org/moratoria)

- [Holland & Knight – CMS Announces Nationwide Enrollment Moratoria for Hospices and Home Health Agencies](https://www.hklaw.com/en/insights/publications/2026/05/cms-announces-nationwide-enrollment-moratoria)

- [Benesch Law – CMS Imposes Nationwide Moratorium on Home Health Agency and Hospice Enrollments](https://www.beneschlaw.com/insight/cms-imposes-nationwide-moratorium-on-home-health-agency-and-hospice-enrollments/)

- [Nixon Peabody – CMS Hospice and Home Health Agency Moratorium: Impact on M&A and Ownership Changes](https://www.nixonpeabody.com/insights/alerts/2026/05/14/cms-hospice-and-home-health-agency-moratorium-impact-on-ma-and-ownership-changes)

- [Ropes & Gray – CMS Announces Nationwide Moratoria on Hospice and Home Health Agency Medicare Enrollments – Key FAQs](https://www.ropesgray.com/en/insights/alerts/2026/05/cms-announces-nationwide-moratoria-on-hospice-and-home-health-agency-medicare-enrollments)

- [AHA News – CMS Announces 6-Month Enrollment Moratorium on Home Health and Hospice Providers](https://www.aha.org/news/headline/2026-05-13-cms-announces-6-month-enrollment-moratorium-home-health-and-hospice-providers)

- [National Law Review – CMS Imposes Nationwide Enrollment Moratoria on Hospices and Home Health Agencies](https://natlawreview.com/article/cms-imposes-nationwide-enrollment-moratoria-hospices-and-home-health-agencies-what)

This article is intended for informational purposes only and does not constitute legal or compliance advice. Providers should consult qualified legal counsel regarding their specific circumstances.