CMS Imposes Nationwide Moratoria on New Medicare Enrollments of Hospices and Home Health Agencies

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Key Takeaways

  • CMS has issued nationwide moratoria on new Medicare enrollments for hospices and home health agencies, effective May 13, 2026, halting all new applications and branch expansions for at least six months.
  • Existing providers may continue operating but may face heightened compliance expectations, while any new applications submitted within six months after the moratoria lift will be subject to heightened scrutiny.
  • The moratoria will indirectly affect Medicaid and CHIP enrollment in states requiring Medicare certification as part of their respective requirements, creating broader access and operational delays across multiple programs.

The Centers for Medicare and Medicaid Services (CMS) has imposed immediate nationwide moratoria on the initial Medicare enrollment of hospices and home health agencies (HHAs), including additions of new branch locations, pursuant to substantially similar Notices to be published in the Federal Register on Friday, May 15, 2026. The moratoria are effective May 13, 2026, and include all states, territories, and the District of Columbia. The initial terms of the moratoria are for six months, but they can be extended for additional six-month increments if CMS deems necessary.

Scope and Operational Impact of the CMS Medicare Enrollment Moratoria

The moratoria apply to all new Medicare enrollment applications for hospice and HHA applicants, including branch locations. As a result, the moratoria will not only temporarily prevent new providers from entering these industries, but they will also postpone existing providers’ plans for de novo expansion and other transactional activity requiring a new application under the existing “36-month rule” (which requires an HHA or hospice to submit an initial application and undergo a state survey or accreditation if it experiences a change in majority ownership (CIMO) within 36 months after its initial enrollment or most recent CIMO, unless an exception applies).

Compliance Considerations for Existing Medicare‑Enrolled Hospices and HHAs

Although CMS declined to extend the moratoria to Medicaid and Children’s Health Insurance Program (CHIP) contexts, deferring to states’ discretion to determine whether such further intervention may be appropriate, some states require Medicare certification as a prerequisite to their respective Medicaid enrollment process. Thus, in states with such interrelated requirements, the Medicare moratoria may also constructively extend to Medicaid and CHIP contexts.

CMS Moratoria Implications for Medicaid, CHIP, and State‑Level Enrollment Requirements

The moratoria do not impact current enrollments, allowing existing providers to continue operations without interruption. Existing enrollees should continue to prioritize their ongoing compliance requirements, including with respect to changes of information and revalidation reporting.

The moratoria do not apply to any of the following:

  • Any enrollment application that has been received by the Medicare contractor prior to the date the moratoria were imposed.
  • Changes in ownership (except non-exempt CIMOs that require an initial enrollment due to the 36-month rule).
  • Changes in practice location (except if the location is changing from a location outside a moratorium area to a location inside a moratorium area).
  • Changes in provider information (such as phone numbers).

New Medicare enrollment applications from home health and hospice providers unable to enroll during the moratoria that are submitted within six months from the date CMS lifts the moratoria will be subject to higher scrutiny, with these areas assigned to the “high” screening level as required by regulation and consistent with CMS’ existing designation of prospective HHAs and hospices within the “high” categorical risk level.

CMS has previously exercised its authority to implement moratoria on new Medicare enrollments for HHAs; ground ambulance suppliers; and, most recently, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers (effective February 27, 2026). From 2013-2018, moratoria for HHA enrollments initially applied on a targeted basis within certain states and counties and later expanded in scope and duration multiple times. CMS’s historical willingness to extend HHA moratoria highlights the possibility that its current enrollment moratoria may also extend beyond their initial six-month terms.

If you have any questions regarding how this may impact your organization or transaction, please contact the authors.

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Key Takeaways

  • CMS has issued nationwide moratoria on new Medicare enrollments for hospices and home health agencies, effective May 13, 2026, halting all new applications and branch expansions for at least six months.
  • Existing providers may continue operating but may face heightened compliance expectations, while any new applications submitted within six months after the moratoria lift will be subject to heightened scrutiny.
  • The moratoria will indirectly affect Medicaid and CHIP enrollment in states requiring Medicare certification as part of their respective requirements, creating broader access and operational delays across multiple programs.

The Centers for Medicare and Medicaid Services (CMS) has imposed immediate nationwide moratoria on the initial Medicare enrollment of hospices and home health agencies (HHAs), including additions of new branch locations, pursuant to substantially similar Notices to be published in the Federal Register on Friday, May 15, 2026. The moratoria are effective May 13, 2026, and include all states, territories, and the District of Columbia. The initial terms of the moratoria are for six months, but they can be extended for additional six-month increments if CMS deems necessary.

Scope and Operational Impact of the CMS Medicare Enrollment Moratoria

The moratoria apply to all new Medicare enrollment applications for hospice and HHA applicants, including branch locations. As a result, the moratoria will not only temporarily prevent new providers from entering these industries, but they will also postpone existing providers’ plans for de novo expansion and other transactional activity requiring a new application under the existing “36-month rule” (which requires an HHA or hospice to submit an initial application and undergo a state survey or accreditation if it experiences a change in majority ownership (CIMO) within 36 months after its initial enrollment or most recent CIMO, unless an exception applies).

Compliance Considerations for Existing Medicare‑Enrolled Hospices and HHAs

Although CMS declined to extend the moratoria to Medicaid and Children’s Health Insurance Program (CHIP) contexts, deferring to states’ discretion to determine whether such further intervention may be appropriate, some states require Medicare certification as a prerequisite to their respective Medicaid enrollment process. Thus, in states with such interrelated requirements, the Medicare moratoria may also constructively extend to Medicaid and CHIP contexts.

CMS Moratoria Implications for Medicaid, CHIP, and State‑Level Enrollment Requirements

The moratoria do not impact current enrollments, allowing existing providers to continue operations without interruption. Existing enrollees should continue to prioritize their ongoing compliance requirements, including with respect to changes of information and revalidation reporting.

The moratoria do not apply to any of the following:

  • Any enrollment application that has been received by the Medicare contractor prior to the date the moratoria were imposed.
  • Changes in ownership (except non-exempt CIMOs that require an initial enrollment due to the 36-month rule).
  • Changes in practice location (except if the location is changing from a location outside a moratorium area to a location inside a moratorium area).
  • Changes in provider information (such as phone numbers).

New Medicare enrollment applications from home health and hospice providers unable to enroll during the moratoria that are submitted within six months from the date CMS lifts the moratoria will be subject to higher scrutiny, with these areas assigned to the “high” screening level as required by regulation and consistent with CMS’ existing designation of prospective HHAs and hospices within the “high” categorical risk level.

CMS has previously exercised its authority to implement moratoria on new Medicare enrollments for HHAs; ground ambulance suppliers; and, most recently, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers (effective February 27, 2026). From 2013-2018, moratoria for HHA enrollments initially applied on a targeted basis within certain states and counties and later expanded in scope and duration multiple times. CMS’s historical willingness to extend HHA moratoria highlights the possibility that its current enrollment moratoria may also extend beyond their initial six-month terms.

If you have any questions regarding how this may impact your organization or transaction, please contact the authors.

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