On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) announced six-month nationwide moratoria on new Medicare enrollments for hospices and home health agencies. CMS stated that the moratoria were needed due to observations of significant potential for fraud, waste or abuse across both provider types. The moratoria apply across the country, and providers should review the moratoria to ensure their plans are not impacted. Below are the key takeaways and action items for affected providers.
- No new enrollments
No new hospice, home health agency, branch or practice location may enroll in Medicare during the six-month moratoria unless the applicable Medicare contractor received the enrollment application before May 13, 2026. The same rule applies to new hospices and hospice practice locations.
- Existing enrollees remain enrolled
Existing Medicare-enrolled hospices and home health agencies will not be removed from the program by the moratoria and may continue furnishing services if they remain compliant with Medicare requirements.
- Severe potential consequences
Non-exempt changes in majority ownership within 36 months of initial enrollment or the most recent ownership change will trigger a new enrollment obligation under the “36-month rule” at 42 C.F.R. § 424.550(b). During the moratoria, these transactions effectively terminate the provider’s current enrollment and block reenrollment.
- Some ownership changes not within scope of moratoria
Ownership changes that do not trigger an initial Medicare enrollment or the 36-month rule will fall outside the moratoria. This means that the moratoria do not affect transactions involving hospices and home health agencies undergoing indirect equity changes or similar transactions that do not trigger an initial Medicare enrollment or the 36-month rule. But given the dramatic consequences of triggering the moratoria, all providers, investors and stakeholders should be very careful.
- New branches and practice locations
The moratoria also apply to new branches and practice locations of hospices and home health agencies, so providers should evaluate whether their transactions trigger initial enrollment treatment under the 36-month rule. This evaluation is particularly sensitive with respect to enrolled hospices and home health agencies because a non-exempt ownership change can convert into a new enrollment obligation that the moratoria prevent from proceeding.
- Judicial and administrative review
There is no judicial review of CMS’s decision to impose the moratoria. Providers may use existing administrative appeal procedures only to contest whether the moratoria apply to them.
- Moratoria set for six months, but CMS may extend or lift
CMS may extend the moratoria for additional six-month increments. It may also lift the moratoria early if the circumstances warranting them have abated, sufficient program safeguards have been implemented, a public health emergency or disaster is declared, or CMS otherwise determines that the moratoria are no longer needed.
- Engage counsel early
Involving legal counsel in advance of the transaction process to evaluate enrollment status, practice-location expansion and ownership-change planning is critical with respect to deals involving home health and hospice providers. Stakeholders that move quickly to assess pending and planned transactions against the 36-month rule and moratoria restrictions will be best positioned to avoid disruptions to Medicare billing and operations.
The moratoria follow a similar approach CMS took with durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), in which CMS implemented a six-month enrollment moratorium and extended the 36-month ownership rule to DMEPOS suppliers effective Jan. 1, 2026. CMS also expanded its Provisional Period of Enhanced Oversight audit scope recently to include Georgia and Ohio in addition to Arizona, California, Nevada and Texas. Taken together, these actions reflect CMS’ continued and intensifying focus on decreasing fraud and abuse in government payer programs across multiple provider and supplier types.
McGuireWoods continuously monitors developments affecting home health and hospice providers and related stakeholders. For more information, contact one of the authors or a member of the Healthcare Compliance, Regulatory & Policy Practice Group.