CMS Announces Nationwide Moratoria on New Medicare Enrollment for Hospices, Home Health Agencies

On May 13, 2026, the Centers for Medicare and Medicaid Services (CMS) announced an aggressive nationwide crackdown on fraud—with the start of six-month moratoria on new Medicare enrollment for hospices and home health agencies (HHAs) and on changes in majority ownership that would require a new enrollment under 42 C.F.R. §450(b).

CMS is authorized under 42 C.F.R. §424.570 to impose a temporary moratorium if the agency determines that there is a significant potential for fraud, waste, or abuse with respect to a particular provider or supplier type, or particular geographic area, or both. The determination is based on a review of existing data that identifies a trend associated with a high risk of fraud, waste, or abuse, including 1) a highly disproportionate number of providers or suppliers in a category relative to the number of beneficiaries; or 2) a rapid increase in enrollment applications within a category.

According to the May 13 announcement, CMS plans to “intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud.” The moratoria will apply to applications for initial Medicare enrollment and certain changes in minority ownership; the moratoria will not impact current enrollments.

HHAs

The Federal Register notice on HHAs from CMS and the Department of Health and Human Services (HHS) states that fraud, waste, and abuse “has been a severe problem for over two decades.”

“Based on our experience, low start-up costs and the home-based nature of the services—with little direct supervision of the persons performing them—help make the HHS arena ripe for fraud,” CMS states.

Regulations promulgated in 2009, for example, require an HHA or hospice undergoing a change in majority ownership within 36 months of its initial enrollment or most recent CIMO to enroll as a new HHA and undergo a state survey or accreditation, with exceptions (42 C.F.R. § 424.550).    

Yet despite these initiatives, HHA program integrity risks are still among the highest of any provider/supplier type, CMS claims—citing problems in California (Los Angeles County), Ohio, Texas, Michigan, North Carolina, and Nevada, as well as a number of criminal convictions nationwide. Thus, the moratorium with respect to HHAs applies to HHAs seeking to enroll anywhere in the United States, including all states, territories, and the District of Columbia.

Note that the current moratorium with respect to HHAs applies to Medicare: CMS has left to each state to decide “whether some form of home health provider moratorium is appropriate for their respective Medicaid and [Children’s Health Insurance Program (CHIP)], and the scope of such moratorium.” Yet CMS encourages states to engage in this analysis, inviting them to consult with the agency on the topic.   

Hospices

A separate Federal Register notice states that the risk “has dramatically increased in the past 7 years to the point where hospices present no less than a payment safeguard threat than HHAs”—citing problems in Arizona, Nevada, Texas, and California (see related EBG blog post here) as well as criminal convictions nationwide. As with HHAs, CMS suggests each state determine whether a hospice moratorium is appropriate for their Medicaid and CHIP programs and the scope of each program, while encouraging each state to engage in this analysis.  

Takeaways

A CMS Medicare contractor will deny the enrollment application of a provider or supplier subject to a moratorium under 42 C.F.R. §424.570.

The current moratoria began May 13, 2026, and will remain in effect for 6 months. CMS may extend the moratoria in six-month increments or lift the moratoria before the end of the initial six-month period.

Once the moratoria are lifted, the providers or suppliers that were unable to enroll because of the moratoria will be assigned to a “high” screening level in accordance with §§ 424.518(c)(3)(iii) and 455.450(e)(2) if such providers or suppliers apply for enrollment at any time within 6 months from the date the moratoria were lifted.

CMS makes clear that a temporary moratorium does not apply to:

• changes in practice location (except if the location is changing from a location outside the moratorium area to inside the moratorium area);
• changes in provider or supplier information, such as phone numbers;
• changes in ownership (except changes in ownership that would require an initial enrollment); or
• any enrollment application that has been received by the Medicare contractor prior to the date the moratorium is imposed.

If you have questions, please reach out to the authors.

Epstein Becker Green Staff Attorney Ann W. Parks contributed to the preparation of this post.