CMS freezes home health enrollments

The Centers for Medicare & Medicaid Services on May 13 imposed a nationwide six-month moratorium on new Medicare enrollments for home health agencies and hospices, part of what the agency described as a broader anti-fraud campaign. The action applies across the country rather than to a single state or metro area, and CMS said it will deny covered applications submitted after the moratorium took effect. (cms.gov) The agency said the pause is aimed at stopping new providers from entering categories it considers at high risk for fraud, waste and abuse. Existing providers can keep serving Medicare patients during the freeze. ### Which providers are actually blocked from enrolling? CMS said the moratorium covers new Medicare enrollment applications from home health agencies and hospices nationwide. (cms.gov) The agency’s enrollment page says it also covers certain non-exempt changes in majority ownership, meaning some ownership transactions filed after May 13 will be denied as well. The CMS FAQ says the policy applies beginning on the effective date of the moratorium and that no new home health agency or hospice providers will be enrolled into Medicare during that period. CMS also said its regulations do not allow exceptions for individual providers or suppliers. ### Does this shut down agencies that are already billing Medicare? (cms.gov) CMS said the moratorium does not affect current enrollments. Existing home health agencies and hospice providers can continue delivering services to Medicare beneficiaries while the enrollment freeze is in place, according to the agency’s May 13 press release. The distinction matters because the action targets entry into Medicare, not ongoing participation by providers that are already enrolled. (cms.gov) CMS said providers can use existing appeal procedures to challenge a denial based on the moratorium, but the appeal would be limited to whether the moratorium applies to that provider or supplier. ### What legal authority is CMS using here? (cms.gov) The Federal Register notices for hospice and home health say the moratorium authority comes from section 6401 of the Affordable Care Act, which added section 1866(j)(7) to the Social Security Act. That provision allows the HHS secretary to impose a temporary moratorium on newly enrolling Medicare, Medicaid or CHIP providers and suppliers when the government determines it is necessary to prevent or combat fraud, waste or abuse. (cms.gov) CMS’ FAQ cites 42 CFR 424.570(a)(2) as the implementing regulation. The agency said it may impose a temporary moratorium when it determines there is significant potential for fraud, waste or abuse tied to a provider type, a geographic area, or both. (cms.gov) ### Why did CMS single out home health and hospice now? CMS Administrator Dr. Mehmet Oz said in the agency’s press release that the government has seen “systemic and deeply troubling fraud” in hospice and home health. The release said the moratorium will give CMS time to intensify investigations, use data analytics and speed the removal of providers suspected of fraud from Medicare. CMS also tied the move to other recent program-integrity actions. (federalregister.gov) The agency said it imposed a separate nationwide moratorium on certain medical supply companies on February 27, 2026, and described the three moratoria now in effect as part of a coordinated federal crackdown. (cms.gov) Separate CMS compliance pages show why documentation remains central in these sectors. CMS said the 2024 Medicare fee-for-service supplemental improper payment data showed a 6.7% improper payment rate for home health, with projected improper payments of $1.1 billion, and a 6.8% rate for non-hospital-based hospice, with projected improper payments of $1.6 billion. Those pages said insufficient documentation was the largest error category for both services. (cms.gov) ### How long does the freeze last, and what happens next? CMS said the moratorium will remain in effect for six months from May 13, 2026. The agency’s enrollment page says it may extend the moratorium in additional six-month increments if CMS deems that necessary. (cms.gov) The next formal markers are already identified in CMS guidance. The agency directs providers to the Federal Register notices, Medicare Administrative Contractor communications and its home health and hospice moratorium FAQ for updates on scope, appeals and duration. (cms.gov 1) (cms.gov 2)