CMS Implements Moratorium on New Medicare Enrollments for Hospices and HHAs

The Centers for Medicare & Medicaid Services (CMS) has implemented a six-month nationwide moratorium on the enrollment of new hospices and home health agencies (HHAs) into Medicare, starting May 13, 2026. This initiative is part of CMS's strategy to enhance program integrity and combat fraud within these healthcare sectors. The moratorium spans all states and territories, including the District of Columbia, aiming to restrict enrollment and mitigate potential high-risk providers while investigations and enforcement actions are underway.

Existing Medicare providers remain unaffected by this moratorium, allowing them to continue their operations uninterrupted. However, the restrictions could impact plans for expansion, pending enrollment applications, new branch locations, and ownership transactions requiring fresh Medicare enrollments. Current providers need to be aware of potentially significant impacts on their business strategies.

Although the moratorium primarily targets Medicare, CMS encourages states to consider similar actions for Medicaid and CHIP providers. Engaging with states and territories, CMS addresses Medicaid and CHIP-related actions. The moratorium can be extended in six-month intervals or lifted earlier should program-integrity concerns be resolved or its necessity cease.

For HHAs, CMS imposes a temporary freeze on new enrollments. Any change in majority ownership not exempt under 42 C.F.R. § 424.550(b) that necessitates registering as a new provider is blocked during the moratorium. This restriction applies equally to hospices facing ownership changes within a 36-month period as outlined by the same regulation, effectively preventing re-enrollment.

Enrollment applications submitted to the Medicare Administrative Contractor (MAC) before May 13, 2026, are exempt from these restrictions. Providers should ensure proper documentation to avoid potential complications. This moratorium serves to halt the entry of new providers deemed high risk for fraud, with CMS focusing on targeted investigations using advanced data analytics during this period.

In conjunction with the moratorium, CMS has initiated significant enforcement actions, including payment suspensions totaling approximately $70 million, primarily targeting hospices and HHAs, particularly in Los Angeles. Additional integrity measures involve increased oversight for new hospice providers in select states, comprehensive enrollment screening for high-risk HHAs, and expanded claim reviews.

Existing providers should anticipate heightened scrutiny as part of a broader enforcement campaign. They should audit internal compliance, review ownership records, referrals, and billing to ensure alignment with CMS's regulatory compliance requirements. As the moratorium represents a substantial intervention, providers and stakeholders must prepare for continued scrutiny, affecting new market entrants and expansion efforts in the hospice and HHA sectors.