Takeaways
- Federal officials have temporarily paused new Medicare enrollments for hospice and home health agencies through November 13, 2026.
- Existing Medicare-certified providers can continue operating and serving patients during the moratoria.
- The freezes seek to address suspected fraud, including improper hospice enrollments, stolen Medicare information, and license flipping.
- Older adults and caregivers should review Medicare billing records, avoid sharing Medicare numbers in exchange for gifts or services, and report suspected fraud.
In May, the Centers for Medicare & Medicaid Services (CMS) announced what it called an “aggressive nationwide crackdown” on fraud in two corners of the health care system that serve millions of older Americans: Medicare hospice care and home health care. CMS imposed two separate six-month moratoria that stopped Medicare from accepting new hospice agencies and new home health agencies (HHAs) across the country.
The moratorium is a temporary freeze rather than a shutdown. It does not close any hospice or HHA that is already enrolled in Medicare and serving patients. Those organizations can continue operating and billing Medicare as usual.
The moratoria block new enrollments. Companies that have not yet been approved cannot enter the program. Meanwhile, agencies seeking a majority ownership change within three years of their last approval must reapply as new providers, which is now impossible until the freezes are lifted.
CMS used its existing authority under federal law to freeze enrollment after data showed a “significant potential for fraud, waste, or abuse.” The agency said the current moratoria were prompted by a surge in hospice and home health applications that raised concern about whether some markets could support so many providers.
Why Regulators Acted
The moratoria follow several years of mounting evidence that fraud in hospice and home health billing has become a large and growing problem.
- Hotspot states. Federal investigators have identified California, Arizona, Nevada, Texas, Georgia, and Ohio as states with increased fraud risk.
- Los Angeles County. A 2022 state audit found the county saw a 1,500 percent increase in hospice providers over the prior decade.
- Enrollment without consent. In some cases, operators used stolen Medicare numbers to enroll people in hospice who never agreed to it and, in some instances, were not even terminally ill, which is the basic requirement for hospice eligibility.
- License flipping. Investigators have also described operators obtaining a hospice license and quickly reselling it before regulators can inspect the business, a practice tied to poor or negligent patient care.
Updates Since the Announcement in May
The moratoria will run through November 13, 2026, and can be extended in additional six-month blocks if CMS decides that’s necessary. In the months since the initial announcement, several developments have added details to how the freeze is playing out:
- Federal Register notices. CMS formally published the moratoria on May 15, 2026. Applications submitted before May 13 will still be processed. Anything filed after that date must be resubmitted once the freeze ends.
- States are following suit. Because the federal moratoria apply only to Medicare, CMS has encouraged states to consider similar actions for their own Medicaid programs.
- Ohio implemented a parallel Medicaid enrollment moratorium on hospice and home health providers, effective May 14 and running through November 14, 2026.
- Arkansas stopped accepting new hospice license applications as of May 13.
- California has had its own statewide hospice licensing moratorium in place since 2022. It remains active and was cited in CMS’s federal notice as an example of a state acting on the problem.
- Enforcement has intensified alongside the freeze. Ohio suspended payments in June to 49 Medicaid home health providers flagged as high-risk by fraud-detection analytics. In Los Angeles, prosecutors have continued to bring cases against hospice operators, including a case alleging a $27 million hospice fraud and kickback operation that enrolled patients who were not terminally ill and in some allegations already deceased at the time of enrollment.
- Industry pushback. Home health and hospice groups, including the National Alliance for Care at Home, have stated that a blanket nationwide freeze could make it harder for hospitals in rural and underserved areas to find home health or hospice partners to accept patients being discharged and are urging a more targeted, data-driven approach instead.
How This Type of Fraud Hurts Older Americans
The fraud harms not only seniors but also the Medicare trust fund.
- Loss of appropriate medical care. Hospice services focus on comfort care rather than curative treatment. If someone is enrolled in hospice without their knowledge, they may lose access to treatments, medications, or hospital care without knowing why.
- Exploitation of trust and vulnerability. Fraudsters may ask seniors for their Medicare numbers and offer cash or other incentives to sign up. Older immigrants and people in communities of color may be especially vulnerable because of language barriers or unfamiliarity with Medicare rules.
- Corrupted records that follow patients. A hospice enrollment, whether real or fraudulent, becomes part of a person’s Medicare history. Beneficiaries have described confusion and difficulty later proving they were never actually terminally ill or never received the billed services.
- Erosion of trust in legitimate care. Widespread fraud can make seniors and families more suspicious of hospice care in general, potentially delaying legitimate end-of-life care that could ease suffering for patients who genuinely need it.
- Financial harm shared by everyone. Fraudulent billing wastes Medicare funds and can make it harder for officials to understand how much care people actually need. In turn, that may affect future policy decisions about Medicare.
What the Moratoria Could Mean for Older Adults
Because current Medicare-certified hospices and home health agencies are unaffected, most people already receiving care should see no disruption. But the freeze on new providers carries potential effects in both directions.
Possible Benefits
- Fewer opportunities for new bad actors to enter the system while CMS investigates and removes existing fraudulent operators.
- More time for regulators to inspect current providers rather than processing new applications that may be intended for resale or fraud.
- A cessation of “license flipping,” since new hospice and home health licenses simply cannot be issued during the freeze.
Possible Concerns
- Reduced access in underserved or rural areas. Hospital groups warn that some communities already have too few home health and hospice options. A freeze on new entrants could make it harder for hospitals to find an agency willing to take a newly discharged patient in those areas.
- No help for people who have already been harmed. The moratoria stop new fraudulent providers from entering but they do not, on their own, undo enrollment errors or billing problems for beneficiaries who were affected before May 2026.
- Uncertainty for legitimate new providers. Ethical operators who were planning to open a hospice or home health agency or complete an ownership change are frozen out along with bad actors until at least November and possibly longer if CMS extends the moratoria.
- A patchwork of state rules. With some states layering their own Medicaid moratoria on top of the federal Medicare freeze, and others taking no action, the rules a family encounters can vary depending on where they live.
What Older Adults and Caregivers Can Do
There are some practical steps you can take when navigating hospice or home health decisions during this period:
- Slow down before signing anything. Hospice is meant for patients with a life expectancy of about six months or less. The decision should always involve a physician you trust, not a recruiter who initiated contact.
- Never share your Medicare number with anyone who calls, texts, or approaches in person offering payment, gifts, or free equipment in exchange for enrolling.
- Review Medicare Summary Notices or your Medicare account regularly for any hospice or home health billing that doesn’t match care you actually received or agreed to.
- Report suspected fraud to 1-800-MEDICARE (1-800-633-4227) or the U.S. Department of Health and Human Services (HHS) Office of Inspector General hotline at 1-800-HHS-TIPS (1-800-447-8477).
- Confirm that a current provider is enrolled and in good standing by asking them for proof and checking with Medicare directly, since the moratoria do not affect agencies that were already approved before May 13, 2026.
Additional Reading
For additional reading on issues related to Medicare, check out the following articles: