As part of an effort to crack down on publicized fraud, the Centers for Medicare and Medicaid Services (CMS) announced on May 13, 2026, a nationwide moratoria on new Medicare enrollments for home health agencies. Lasting for an initial period of six months, which CMS may extend for additional six-month increments, the moratorium prohibits new Medicare enrollment of home health agencies, but will not impact changes in practice location, changes in provider or supplier information (such as phone numbers or addresses), or changes in ownership (with the exception of changes in majority ownership affected by the home health agency so-called “36-Month Rule”).
CMS has long designated home health agencies as high risk for fraud, waste, and abuse to the Medicare program. Previously, on July 31, 2013, CMS imposed a moratorium on new Medicare enrollment for home health agencies located in select counties in Florida, Illinois, Michigan, and Texas. That moratoria ended on Jan. 30, 2019.
Further, CMS has required home health agencies to undergo additional screening for Medicare enrollment, such as requirements for reserve operating funds, increased fingerprinting requirements for those with 5% or greater ownership interests, and the imposition of the 36-Month Rule, which required a home health agency undergoing a change in majority ownership (defined as a change in more than 50% of the direct ownership of the home health agency through an asset sale, stock transfer, consolidation, merger, or a combination of those events) within 36 months of its initial enrollment or last change in majority ownership to newly enroll in Medicare, unless certain exceptions apply. CMS also required new home health agencies to undergo a provisional period of enhanced oversight, such as prepayment review and payment caps.
Despite these initiatives, CMS states that home health agencies remain among the highest program integrity risks. As an example, Los Angeles County saw a 40% increase in home health agency enrollment between 2019 and 2023 despite no evidence of medical need or other justification for this increase. Similar trends exist in Ohio, Michigan, Nevada, North Carolina, and Texas.
Given the breadth of fraud, waste, and abuse to the Medicare program, CMS believes that its prior anti-fraud measures for home health agencies have not been effective. For this reason, beginning on May 13, 2026, CMS is imposing a nationwide moratorium on all new home health agency Medicare enrollments, including new enrollments for home health agency branch locations. The moratorium will not prohibit processing a Medicare contractor’s enrollment application if it was received before May 13.
Regarding transactions, the moratorium will prohibit a home health agency undergoing a non-exempt change in majority ownership from re-enrolling in the Medicare program because, under the 36-Month Rule, that action constitutes a “new” enrollment. Parties contemplating home health agency transactions should consider the impact of the moratorium.
For now, the moratorium will last for six months and apply only to Medicare enrollments. It does not apply to Medicaid or CHIP enrollments. CMS, at this time, is allowing each state to consider whether to expand the moratorium to its Medicaid or CHIP program.