CMS extends hospice, home health enrollment freeze 6 months

The Centers for Medicare & Medicaid Services (CMS) will extend the nationwide moratoria on new Medicare enrollment of hospices and home health agencies (HHAs) for six more months, effective Nov. 12, 2026. In October, CMS site visit teams ran a two-day operation targeting HHAs and hospices in California that produced 145 revocations of providers associated with more than $703 million in Medicare and Medicaid payments. CMS announced the extension on Nov. 12.

What the extension covers

The extension applies to new applications for initial Medicare enrollment, including hospices and HHAs that initially enroll under a nonexempt change in majority ownership (CIMO) under 42 CFR 424.550(b). The initial moratoria began May 13, 2026.

CMS consulted the Department of Health and Human Services Office of Inspector General (HHS OIG), which agreed there remains a significant potential for fraud, waste or abuse in Medicare with respect to hospices and HHAs, according to the hospice notice and the home health notice. Both notices are scheduled for Federal Register publication on Nov. 16, 2026.

Existing enrollments and services are not affected. The notices state that CMS has seen no evidence the May 2026 moratoria materially reduced Medicare beneficiary access on a nationwide or state level.

States decide on their own Medicaid and CHIP moratoria. Five states, Louisiana, Nevada, Ohio, Pennsylvania and Rhode Island, have implemented hospice moratoria in response to the May notice. Ohio and Rhode Island have implemented home health moratoria. The extension is not intended to affect those existing state moratoria.

What changed from May

The May moratoria also covered new hospice practice locations and new HHA branches. The extension drops that coverage. Currently enrolled hospices may again add practice locations, and currently enrolled HHAs may again add branches. The freeze on additions ends on the effective date.

CMS said the change reflects greater concern about new providers, with whom it may have no experience, than about enrolled providers adding a location or branch.

Why it matters

Buyers still face a freeze on new enrollment tied to majority ownership changes. An acquisition structured as a nonexempt CIMO cannot produce a new Medicare enrollment during the extension.

Health plans and health systems contracting with post acute providers should expect continued supply limits on new hospices and HHAs. Existing agencies can expand their footprints through new locations and branches.

CMS cited clusters as a reason to keep the freeze. In Ohio, it found at least nine cases where at least five HHAs shared one practice location address. Four of those cases involved at least nine HHAs at one address, and one location had 18 HHAs. It reported similar situations in Texas, Michigan, North Carolina and Nevada.

The hospice notice listed fraud schemes, including enrolling beneficiaries without consent, billing for patients who were not terminally ill, and opening hospices to sell them for a profit.

The CY2027 home health rule finalized enrollment changes. All revocations will be retroactive to the date of noncompliance. Providers must reenroll after certain majority ownership changes. The rule adds consequences when a provider, owner or managing employee has a license, Medicaid or federal program suspension or revocation. It also targets clusters of agencies in small areas and medical directors who oversee several hospices or work too far away to do the job.

“We’ve made real progress over the past six months, but fraud in hospice and home health persists and our work isn’t finished,” CMS Administrator Dr. Mehmet Oz said in the release. “Medicare beneficiaries deserve protection from these bad actors, and American taxpayers need to know the programs they rely on aren’t being bled dry by fraudsters.”