CMS Announces Nationwide Moratoria on Hospice and Home Health Agency Medicare Enrollments - Key FAQs for Hospice Providers and Home Health Agencies

On May 13, 2026, CMS announced an imminent nationwide six-month moratoria on the Medicare enrollment of new hospices and home health agencies (HHAs), citing concerns regarding rapid growth in enrollments, improper ownership transfers, and alleged fraudulent billing activity.¹ The moratoria follows closely on the heels of CMS’s February 2026 nationwide enrollment moratorium applicable to certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers and signals an increasingly aggressive provider-enrollment and program-integrity enforcement posture by the agency.²

Key Transactional Implications: The two moratoria create potentially significant implications for home health and hospice transactions, de novo expansion strategies, and provider enrollment timelines.

What Do the Moratoria Prohibit? The moratoria prohibit CMS from processing new (i.e., “initial”) Medicare enrollment applications for HHAs and hospices nationwide during the applicable moratorium period. Bottom line: once the moratorium takes effect, CMS will not issue new Medicare provider transaction access numbers (PTANs) to hospice or HHA providers.

The moratoria are expected to impact:³

• hospice and HHA providers seeking initial Medicare enrollment for practice locations including:
  • transactions involving existing hospice or HHA providers where the buyer will not accept assignment of the seller’s existing provider agreement/PTAN;
  • certain transactions (stock deals or otherwise) implicating CMS’s hospice/HHA “36-month rule,” under which certain changes in majority ownership—including transactions where the direct owner or parent entity of the enrolled provider changes within 36 months of the provider’s initial enrollment or a prior change in majority ownership—require the provider to reenroll as a new provider and obtain a new PTAN⁴; and
  • add-ons that require a new PTAN to be issued as opposed to just adding a practice location to an existing PTAN (such as de novo add-ons in a new state).

Importantly, the moratoria will not impact the following:

• Changes in practice location (depending on and assuming such change does not require a separate provider enrollment);⁵
• Changes or updates to practice information, such as phone numbers or contact information for the practice;⁶
• Ownership changes so long as the seller’s PTAN/provider agreement is assumed by the buyer and the 36-month rule is not implicated;⁷ and
• any enrollment application that has been received by the Medicare contractor prior to the date the moratorium is imposed.⁸

When will the moratoria be lifted? The moratorium is set to remain in effect for an initial six-month period commencing on May 13, 2026.  However, both the proposed notices and existing CMS regulations expressly authorize CMS to extend the moratorium in successive six-month increments if the agency determines continued action is warranted based on fraud, waste, or abuse concerns.

Does the moratorium have any impact on Medicaid enrollments? The moratorium does not automatically apply to Medicaid enrollments. Instead, CMS has stated it is deferring to individual state Medicaid agencies to determine whether to implement comparable enrollment moratoria for its Medicaid or CHIP programs. CMS has nevertheless encouraged states to consider adopting targeted HHA and hospice moratoria tailored to state-specific compliance risks, provider populations, beneficiary needs, and geographic considerations, and indicated that it is available to consult with states evaluating whether to implement such measures.⁹

Practical Implications: In light of the moratoria, hospice and HHA providers, investors, and transaction parties should consider the following practical and transactional implications:

• promptly reviewing pending and contemplated transaction structures (especially de novo strategies);
• evaluating whether preserving the existing provider agreement/PTAN is operationally feasible and commercially advisable and, if not, how to mitigate risk if the PTAN is assumed;
• analyzing potential hospice/HHA 36-month rule implications early in the diligence and structuring process; and
• reassessing transaction timelines given anticipated enrollment delays.

We are actively monitoring CMS guidance and implementation activity related to the moratoria and would be happy to discuss implications for pending transactions, de novo strategies, enrollment planning, or other operational considerations.

Please speak with your Ropes & Gray representative if you have questions.