CMS Hospice and Home Health Enrollment Freeze Nears Expiration With No Extension Announced

A Decision Approaching and CMS Has Yet to Respond

A nationwide moratorium that has prevented new hospices and home health agencies from enrolling in Medicare since May is due to expire on Nov. 13, and federal officials have not said whether it will be kept in place.

CMS had told providers it would provide at least 60 days' notice before the moratoria ended, according to Home Health Care News. As of Oct. 30, no extension had been announced, leaving hospitals, discharge planners, and families uncertain about what the end-of-life and in-home care landscape will look like in the near future.

For families, the issue is far from abstract. Hospice and home health services can allow a dying parent to remain at home or help someone recovering from a stroke receive nursing care without moving into a facility. The freeze does not apply to agencies already enrolled in Medicare, and it does not interrupt care for people already receiving services. It does, however, keep new agencies from joining the program, including in counties where options are already scarce.

CMS says the policy is producing results. Kimberly Brandt, the agency's deputy administrator and chief operating officer, told providers at the National Alliance for Care at Home annual conference that the freeze is aimed at a specific set of bad actors rather than the field as a whole. "We're going through the bad actors. We're not going after people like you," she said, according to Hospice News.

Families Seeking End-of-Life Care Face Limited Options

The greatest pressure falls on households in places with few providers to begin with. If a rural county has only two hospice agencies and one shuts down or stops accepting referrals, no new Medicare-enrolled agency can move in while the freeze remains. That can mean longer travel, waiting lists, or a loved one staying in the hospital longer than necessary.

The American Hospital Association raised that concern when the policy took effect. In its statement on the moratoria, the group said rural and underserved areas often struggle to find appropriate discharge options and that home health and hospice providers are critical to safe transitions in care. CMS has said it does not expect the freeze to jeopardize access and will keep monitoring for problems.

Caregivers should not assume their current provider is affected. Existing agencies continue to bill and admit patients normally. The people most likely to feel the impact are those trying to begin services in communities where capacity has recently shrunk, along with families whose chosen provider was being sold or opening a new branch.

The Enforcement Drive Behind the Moratoria

The two moratoria took effect on May 13, 2026, and were announced in a CMS press release citing fraud in the sector. The freeze blocks new Medicare enrollment for hospices and home health agencies, as well as new branch and practice locations and certain majority-ownership changes.

During the freeze, CMS has denied 50 hospice applications and 250 home health applications, Brandt said. The agency has also seen a steep decline in billing in states it views as high risk for fraud, including California, Texas, Nevada, Ohio, Georgia, and Arizona.

Brandt said CMS has suspended payments to 899 hospice and home health providers, including 812 in California, totaling $1.4 billion. She acknowledged that legitimate providers can be caught in the sweep as well. "I'm not looking to catch the good people," she said, while adding that some would inevitably be included.

CMS can extend the moratoria only in six-month increments, and any extension must be published in the Federal Register, according to the agency's notice. The same notice says CMS can also lift a moratorium early.

Lawyers who advise these companies say the market remains on hold. Rachel Hold-Weiss, a healthcare partner at Benesch Law, told Home Health Care News that smaller owners hoping to sell have been left stranded and that some Medicare contractors have rejected applications filed before the freeze began. Lanchi Bombalier, a healthcare partner at Arnall Golden Gregory, told the publication that the uncertainty "certainly does chill the industry a little bit."

Possible Outcomes for CMS, Providers, and Patients

CMS has three main choices. It can allow both moratoria to expire, reopening enrollment and potentially creating a backlog as delayed applications and stalled sales move at once. It can extend them for another six months, pushing them into May 2027. Or it can narrow the policy to specific high-fraud markets, as several industry groups have urged.

CMS allowed a separate enrollment freeze on durable medical equipment suppliers to expire earlier this year, though the agency has not linked that decision to the hospice and home health moratoria.

Families should not make changes based on the deadline alone. If a relative is already receiving hospice or home health care, that care continues regardless of what CMS decides. Anyone arranging new services should ask the hospital discharge planner or case manager how many Medicare-certified agencies serve the area and whether any have recently stopped accepting referrals. Patients who believe they have seen unauthorized billing can report it by calling 1-800-MEDICARE.

MedicalDaily will update this story when CMS announces its decision.

Key Questions Answered

What exactly is ending on Nov. 13? Two nationwide Medicare moratoria that have blocked new hospices and home health agencies from enrolling in Medicare since May 13. They also cover new branch locations and some ownership changes.

Will my parent lose hospice or home health care? No. The freeze applies only to new agencies entering Medicare. Agencies already enrolled continue to operate, bill, and admit patients normally.

Why did CMS do this in the first place? The agency cited widespread fraud, including hospices certifying patients who were not terminally ill and billing for services that were never provided. Brandt said CMS has suspended $1.4 billion in payments to 899 providers.

Who is most likely to be affected? People in rural and underserved areas with few existing agencies, and families whose chosen provider was in the middle of a sale or expansion when the freeze began.

Has CMS said whether it will extend the freeze? Not as of Oct. 30. Any extension would be published in the Federal Register and would run six months.

What should I do if I cannot find an agency? Ask the hospital case manager or discharge planner for every Medicare-certified option in your area, contact your State Health Insurance Assistance Program for free counseling, and use Medicare's Care Compare tool to check certified providers near you.