On May 13, 2026, CMS imposed a nationwide six-month Medicare enrollment moratorium affecting new home health agencies (HHAs) and hospice providers. CMS’s sudden mandate does not simply affect start-ups; it also creates immediate compliance and enforcement implications for existing HHA providers.
What Happened?
CMS announced that, effective May 13, 2026, no new home health agencies, branches or practice locations, hospices, or hospice practice locations will be enrolled in Medicare if the applicable Medicare contractor did not receive the enrollment application before the moratorium’s effective date. The suspension applies nationwide, including all states, territories, and the District of Columbia, will remain in effect for six months and may be extended in additional six-month increments if CMS determines that an extension is necessary.
The freeze generally applies to initial Medicare enrollment applications and to certain changes in majority ownership that require a provider to re-enroll in Medicare (under 42 C.F.R. § 424.550(b).) CMS’s Q&A states that applications submitted after implementation of the moratorium will be denied. Read the full Q&A here.
Existing enrolled providers are not barred from continuing to participate in Medicare, submitting claims for covered services, or making certain enrollment information changes, provided they remain compliant with Medicare requirements. CMS also stated that enrollment applications received by the Medicare contractor before the date the moratorium was imposed are exempt.
Importantly, CMS’s regulations do not permit individual exceptions to the moratorium, and any administrative appeal of a denial based on the moratorium is limited to whether it applies to the provider or supplier. CMS also stated that there will otherwise be no judicial review of CMS’s decision.
What Does the CMS Moratorium Mean for Existing HHA and Hospice Providers?
The moratorium is a significant escalation in Medicare enforcement for the home health and hospice sectors, and a clear signal that CMS now views these industries as presenting systemic fraud risk warranting extraordinary intervention. CMS described the freeze as part of a broader effort to “stop fraud before it starts,” and the agency cited recent actions including payment suspensions involving 773 hospices and 23 HHAs in Los Angeles, representing $70 million in suspended funds. CMS also identified other current oversight measures, including revocations and deactivations, nationwide hospice site visits, enhanced hospice oversight in states with elevated fraud risk, enhanced screening for HHAs, and expansion of pre- and post-claim review for HHA claims in Florida, Illinois, Oklahoma, Ohio, North Carolina, and Texas.
Critically, CMS’s enforcement posture reflects an expectation that providers bear responsibility for fraudulent activity occurring within their operations, even when the wrongful conduct is carried out by third parties such as contracted marketers, referral sources, staffing companies, or independent sales representatives. Federal enforcement authorities have made clear that a provider cannot insulate itself from liability by outsourcing patient acquisition, marketing, or other functions to outside parties. CMS, OIG, and DOJ have repeatedly pursued enforcement actions against providers based on the conduct of their agents, contractors, and referral partners, and providers that fail to implement adequate oversight and compliance controls over these relationships face significant exposure, including revocation, civil monetary penalties, False Claims Act liability, and exclusion from federal health care programs.
For HHAs, CMS emphasized that fraud, waste, and abuse (FWA) has been a serious concern for more than two decades and cited the low start-up costs and home-based nature of services as factors that make the sector vulnerable to fraud. CMS also noted that home health agencies are among a small number of provider and supplier types in the “high” screening category, which can involve site visits and fingerprint-based background checks for certain owners.
For hospice providers, CMS cited HHS-OIG’s concerns about poor quality of care, beneficiary enrollment without consent, inappropriate billing, limited transparency, payment incentives to minimize services, and rapid growth in new hospices. OIG also reports that about 1.8 million Medicare beneficiaries receive hospice care each year and that Medicare pays about $27.5 billion annually for this care, underscoring why hospice remains a high-priority enforcement area.
HHA and Hospice providers cannot overlook the moratorium as a problem only for new entrants. The same enforcement climate that led CMS to close the front door to new enrollment will almost certainly intensify scrutiny of current providers.
How Does the Enrollment Freeze Affect HHA and Hospice Acquisitions and Ownership Changes?
HHA and Hospice providers contemplating expansion should immediately reassess plans for new branches, practice locations, acquisitions, startups, or enrollment-based growth. Any transaction involving a change in majority ownership within the applicable 36-month period should be reviewed carefully because a non-exempt change may require initial enrollment as a new provider and may therefore be blocked by the moratorium.
Organizations that already submitted applications before May 13, 2026, should confirm and preserve proof of timely receipt by the applicable Medicare contractor. Providers that have pending changes should evaluate whether the change is a permissible update, such as certain provider information changes, or a prohibited initial enrollment or non-exempt ownership change.
What Steps Should HHA and Hospice Providers Take Now?
HHA providers should begin by performing targeted claims and documentation audits and strengthen their compliance infrastructure, focusing on documentation, plans of care, medical necessity, skilled need, coding, assessments, visit records, and billing consistency. For hospices, the audit should focus on terminal prognosis support, election statements, levels of care, certifications and recertifications, services furnished, non-hospice spending, and beneficiary consent issues. Organizations should use those findings to update policies, training, reporting channels, monitoring plans, disciplinary standards, and corrective action processes.
Providers should pay particular attention to marketing, referral, and sales practices, including referral source relationships, compensation arrangements, lead generation, patient acquisition strategies, gifts, incentives, and any arrangements that may implicate federal or state fraud and abuse laws. They should also validate readiness for site visits, surveys, and documentation requests by confirming that practice locations are accurate, operational, licensed, staffed, and supported by current records and quality materials.
Finally, providers should maintain a privileged overpayment and disclosure protocol and elevate moratorium-related issues to board, owner, or sponsor oversight. OIG materials emphasize self-disclosure, identifying and returning overpayments, strengthening documentation, and conducting internal audits based on identified risk areas. Leadership should receive regular reporting on moratorium impact, audit results, hotline activity, corrective actions, repayment activity, referral arrangements, survey readiness, transaction risk, and updates from CMS, state Medicaid agencies, and state licensing authorities.
How Can Frier Levitt Help HHA and Hospice Providers Navigate the Moratorium?
The moratorium is more than a temporary enrollment pause; it is a signal that CMS views home health and hospice as priority enforcement sectors. For HHA providers, enrollment strategy, ownership, billing compliance, clinical documentation, marketing and referral arrangements, audit response, overpayment analysis, and potential disclosures should be evaluated with experienced health care counsel.
Frier Levitt is a boutique healthcare law firm exclusively focused on the healthcare industry. We represent home health agencies, hospices, and other providers facing Medicare enrollment issues, government audits, compliance challenges, and fraud and abuse risk. We understand what’s at stake for your business — and we know how to protect it.
Frier Levitt can help assess pending applications, majority ownership changes, Medicare contractor communications, audit responses, overpayment issues, voluntary disclosures, and interactions with CMS, OIG, DOJ, UPICs, state survey agencies, and Medicaid agencies, while protecting communications under the attorney-client privilege. The review should confirm whether any pending application or ownership change is permitted during the moratorium, preserve proof of any pre-May 13 submissions, and identify transaction, expansion, or licensing steps that may require immediate adjustment.
Contact Frier Levitt today for a privileged review of your Medicare enrollment status, pending applications, or ownership transaction risk under the 2026 CMS moratorium.
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