The Centers for Medicare & Medicaid Services (CMS) on May 13, 2026 announced a nationwide temporary moratorium on new Medicare enrollments for hospices and home health agencies, representing a significant escalation in the agency’s use of front-end program integrity tools. The moratorium applies across all states and is effective immediately, with an initial duration of six months and the potential for extension.
Key Takeaways
- CMS has imposed a nationwide, six-month moratorium on new Medicare enrollments for hospices and home health agencies. This moratorium will allow CMS to intensify targeted investigations, deploy advanced data analytics, and accelerate removal of agencies suspected of committing fraud, according to the CMS May 13 press release.
- The moratorium applies to initial enrollments and certain changes in majority ownership that do not qualify for an exception to the 36-month rule.
- Pending enrollment applications submitted and received before the May 13 effective date will continue to be processed, but new applications will be denied pursuant to the moratorium.
- Changes in practice locations of hospice “multiple locations” or home health “branches” are not, according to CMS’s moratorium FAQs, affected by this temporary moratorium, though new multiple location/branch requests may be affected by the moratoria. For instance, the California Department of Public Health restricted new multiple locations under its state licensure moratorium for hospice.
- Providers should expect heightened scrutiny of enrollment, ownership, and compliance practices, even if not directly subject to the moratorium.
- Vice President JD Vance, CMS Administrator Dr. Mehmet Oz, and Deputy Administrator Kim Brandt announced other hospice fraud efforts, including 800 hospice payment suspensions in California in a May 13 White House press conference discussing the new hospice and home health moratorium. Ms. Brandt also announced a new “Medicaid War Room,” signaling increased real-time focus not just on Medicare claims but on Medicaid claims as well.
Background on CMS’s Moratorium Authority
CMS’s moratorium authority (42 CFR § 424.570) permits temporary enrollment moratoria where the agency identifies a “significant potential for fraud, waste, or abuse.” The Federal Register notice enacting the moratorium emphasizes that this decision is data-driven, citing rapid provider enrollment growth, high provider-to-beneficiary ratios, and other program integrity risk indicators—what CMS characterizes as a nationwide issue impacting even historically lower-risk states, such as Oklahoma, Utah, and Louisiana.
While the CMS Moratorium FAQs note that CMS has previously imposed moratoria under the same authority, those have always been limited geographically. This hospice moratorium, along with the durable medical equipment moratorium CMS announced on February 27, 2026, are the first instances of CMS using this authority to impose nationwide moratoria.
Applicability of the Moratoria
The moratoria apply to:
- initial Medicare enrollment applications for hospices and home health agencies; and
- changes in majority ownership that require new enrollment under Medicare rules, unless an exception applies (e.g., death of the prior owner).
The moratoria do not apply to:
- currently enrolled providers;
- applications submitted prior to the moratoria’s effective date;
- revalidations;
- most practice location changes; and
- routine enrollment updates (e.g., phone number changes).
Notably, the CMS Home Health and Hospice Nationwide Moratorium Q&A confirms that the new hospice moratorium will not impact the telehealth flexibilities currently available for hospice face-to-face recertification requirements. This is a welcome departure from the recent congressional spending package language, which ostensibly extended the ability to conduct hospice face-to-face recertification encounters via telehealth through December 31, 2027, but prohibited the use of telehealth for encounters where the patient is located in an area subject to a hospice enrollment moratorium.
Recommendations
Given the immediate effect of the moratorium, stakeholders should take a structured approach:
- Evaluate enrollment exposure: Providers should identify any pending or planned initial enrollment applications to assess whether they will be impacted by the moratorium.
- Strengthen compliance functions: Providers should evaluate current compliance and billing practices to prepare for potential increased scrutiny. In its press release on the moratorium, CMS emphasized other avenues through which it has attempted to “crush” fraud among hospice and home health providers, including revocations and deactivations, targeted site visits, heightened scrutiny in states subject to a Provisional Period of Enhanced Oversight (PPEO), and enhanced enrollment screening measures. As a result, providers should expect increased attention to enrollment and compliance infrastructure, including with respect to the accuracy of PECOS filings, the completeness of ownership disclosures, and compliance with clinical and billing requirements, particularly in light of CMS’s increased reliance on data mining and analysis.
- Carefully Assess transaction structuring Options: Providers and investors should reassess deal timelines and evaluate alternative structures where feasible with the understanding that CMS has the authority to continue to extend the moratorium period beyond the initial six-month pronouncement. The FAQs provide that, unless a certain exception applies, if a home health agency or hospice undergoes a change in its majority ownership within 36 months after its initial enrollment, it would be considered a “new provider” and subject to the moratorium. This may delay or prevent closings that depend on enrollment approval and introduce additional regulatory closing conditions. Of course, the 36-month rule was in place for hospice and home health before the May 13 moratorium, and CMS has not used the moratorium to change that rule in any way.
- Monitor CMS guidance: Although the moratorium is currently set for a period of six months, providers should monitor the Federal Register for extension notices that prolong the moratorium period, as well as watch for additional FAQs or other clarifications on moratorium applicability from CMS.
Looking Ahead
The nationwide hospice and home health enrollment moratorium is best understood not as a one-off action but as part of a broader recalibration of CMS’s program integrity strategy for high-risk provider sectors. In the near term, providers and investors should expect continued and aggressive regulatory scrutiny, including coordinated enforcement activity between CMS and federal law enforcement agencies.
How We Can Help
Our team stands ready to advise hospices and home health agencies on the implications of this moratorium on your organization.