CMS freezes hospice, home-health enrollments

The Centers for Medicare & Medicaid Services on May 13 imposed a six-month nationwide moratorium on new Medicare enrollments for hospices and home health agencies, expanding an anti-fraud campaign the Trump administration has tied to Vice President JD Vance’s task force. The action blocks initial Medicare enrollment applications in those categories and also applies to certain changes in majority ownership, which CMS said are often used to mask control by bad actors. (cms.gov) Existing providers can keep serving Medicare patients, CMS said, and the agency said the moratorium may be extended in six-month increments if it decides that is necessary. CMS Administrator Mehmet Oz said the agency was acting after seeing what he called “systemic and deeply troubling fraud” in hospice and home health. (cms.gov) CMS said it would use the six-month window to intensify investigations, expand data analytics and accelerate removals of providers suspected of fraud. The agency said the nationwide scope is meant to stop operators from moving across state lines to avoid scrutiny. ### Which providers are blocked from enrolling? Beginning May 13, no new home health agencies or hospice providers can enroll in Medicare, according to CMS’s moratorium FAQ. The freeze applies to initial applications and to certain changes in majority ownership, and applications filed after the moratorium took effect will be denied. (cms.gov) 42 CFR 424.570 allows CMS to impose a temporary moratorium when it determines there is significant potential for fraud, waste or abuse for a provider type or geography, the agency said. CMS said providers can appeal a denial only on the narrow question of whether the moratorium applies to them, and the rules do not allow individual exceptions. ### What did CMS say drove the move? CMS said hospice and home health had become “high-risk categories” for improper billing and fraud. (cms.gov) The agency pointed to prior enforcement in Los Angeles, where it said payments to 773 hospices and 23 home health agencies suspected of fraud had been suspended, representing $70 million in suspended funds so far. (cms.gov) The agency also linked the new action to a broader series of anti-fraud steps taken this year. CMS said it had already imposed a separate nationwide moratorium, effective February 27, 2026, on Medicare enrollment for medical supply companies. ### How does California fit into the story? Vice President JD Vance said on May 13 that the administration was also deferring $1.3 billion in Medicaid reimbursements to California over fraud concerns, according to reports from multiple outlets. (cms.gov) CMS documents published earlier this year said the agency had identified more than $1.6 billion in federal funds it was recouping from California through voluntary recoveries and deferrals of future Medicaid payments. (cms.gov) A January 27 CMS letter to Governor Gavin Newsom said California accounted for more than 88% of the $1.8 billion CMS was recouping from seven states and Washington, D.C., in that review. The same letter said California home health spending rose more than 21% in 2024, which CMS described as the fastest growth among major health categories nationwide. (cms.gov) ### Has CMS used this tool before? CMS said it previously imposed enrollment moratoria between 2013 and 2018 on home health agencies and ground ambulance suppliers. Those earlier actions were targeted to states and localities including Florida, Michigan, Texas, New Jersey, Harris County and Broward County, and the last of those moratoria expired in 2019. The current action is broader. (politico.com) CMS described the May 13 order as a nationwide moratorium for hospice and home health, rather than a state-by-state freeze. ### What happens next for providers and patients? For now, current hospices and home health agencies remain enrolled and can continue billing Medicare, CMS said. (dhcs.ca.gov) New applicants filed after May 13 will be denied, and CMS said notices about the moratorium will also be distributed through Medicare administrative contractors, stakeholder alerts and Federal Register postings. The six-month moratorium runs into November 2026 unless CMS lifts it earlier or extends it. (cms.gov) Any next formal step is expected to appear through CMS notices and the Federal Register channels the agency identified in its guidance. (cms.gov)