Trump administration to pause new Medicare enrollment for home health providers

The Medicare crackdown is broad enough to catch bad actors quickly, but it also risks slowing the arrival of legitimate hospice and home health providers in places where aging patients already struggle to find care. The Centers for Medicare & Medicaid Services said it was imposing a six-month nationwide moratorium on new Medicare enrollment for hospices and home health agencies, with applications for initial enrollment and some majority-ownership changes to be denied once the pause takes effect.

CMS said existing enrollments were not affected, and current providers could keep serving Medicare beneficiaries. The agency said the action was being carried out in coordination with Vice President JD Vance’s Anti-Fraud Task Force, which has pressed for tougher action against what administration officials describe as widespread abuse in Medicare billing and provider enrollment. A Vance spokesperson said fraud had gone on for far too long and said the administration was finally putting a stop to it.

The move followed months of escalating enforcement. CMS said it had already suspended payments to 773 hospices and 23 home health agencies suspected of fraud in Los Angeles alone, freezing $70 million in funds. The agency also pointed to a nationwide moratorium on certain DMEPOS suppliers announced on February 27, 2026, and said it had used similar authority before, including moratoria from 2013 to 2018 in Florida, Michigan, Texas, New Jersey, Harris County, Texas, and Broward County, Florida. Those earlier restrictions expired in 2019.

Hospice billing has been under closer scrutiny since December 2025, when CMS placed newly enrolling hospices in Arizona, California, Nevada, Texas, Georgia and Ohio under provisional enhanced oversight because of fraud, waste and abuse concerns and rapid enrollment growth. CMS later said that enhanced oversight in four elevated-risk states led to more than 200 hospice Medicare enrollment revocations. Its April 2026 hospice monitoring report also showed the number of hospices slipping from 6,732 in fiscal 2024 to 6,642 in fiscal 2025, while annual hospice spending climbed from $23.0 billion in fiscal 2021 to $30.3 billion in fiscal 2025. Live discharges rose from 16.9% to 19.1% over that same span.

The scale of the benefit helps explain why the issue has become politically charged. The HHS Office of Inspector General says about 1.8 million Medicare beneficiaries receive hospice care each year, and Medicare spends about $27.5 billion annually on that care. OIG investigators have found schemes involving beneficiaries enrolled without consent, inappropriate billing, limited transparency, incentives to minimize services and rapid growth in new hospices.

Provider groups split over how far CMS should go. The National Partnership for Healthcare and Hospice Innovation urged CMS in March 2026 to impose a temporary nationwide moratorium. But Tim Rogers of the Association of Home and Hospice Care of North Carolina and Paul Ledford of the Florida Hospice and Palliative Care Association called such a move “overkill” in an April letter, warning that blanket restrictions could slow legitimate expansion in states that need more capacity and could affect telehealth flexibility for the required hospice face-to-face encounter in rural and shortage areas. A health care fraud takedown on April 2, 2026, in which IRS Criminal Investigation said eight defendants were arrested over more than $50 million in alleged losses tied to sham hospice facilities, showed why officials argue enrollment controls matter.