If you were planning to open a Medicare-certified home health agency or hospice in the United States right now, read this first. On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) imposed a nationwide, six-month moratorium on new Medicare enrollment for home health agencies (HHAs) and hospices. This home health and hospice moratorium is part of a broad anti-fraud crackdown, and it changes the playbook for anyone entering these markets in 2026.
Here is the plain-English version: what is frozen, what is not, and what to do about it.
What the home health and hospice moratorium does
CMS announced the freeze in two Federal Register notices, one for home health agencies and one for hospices, both effective May 13, 2026. The moratorium applies across every state and US territory, including the District of Columbia. It runs for an initial six months, through approximately November 13, 2026, and CMS can extend it in further six-month blocks. If CMS extends it, CMS will publish the extension in the Federal Register.
While it is in force, CMS will not accept or process new Medicare enrollment applications for:
- new home health agencies and hospices (applications submitted on or after May 13, 2026),
- new branches or other new practice locations opened by existing providers, and
- changes of majority ownership that would trigger a new enrollment under the "36-month rule" (more on that below).
What the moratorium does not do
This is the part that matters for planning, so read it carefully:
- Existing agencies keep operating. If you are already enrolled, you continue to bill and serve patients as normal.
- Applications filed before May 13, 2026 keep moving. If your enrollment was already in the pipeline, CMS continues to process it. (If this is you, confirm and keep proof of the date the contractor received your application.)
- Non-Medicare services are not affected. This is crucial. The freeze is on Medicare enrollment. It does not stop you from getting a state license for non-medical home care, launching a private-pay home care business, or opening services that do not bill Medicare. Those routes remain fully open.
- Some ownership changes still work, for example where the buyer assumes the seller's existing provider number and the 36-month rule is not triggered.
- Routine updates continue. The moratorium does not apply to moving an existing practice location or to updating details such as your phone number or address.
A quick word on the "36-month rule"
The 36-month rule says that if a home health agency or hospice changes majority ownership within 36 months of its initial Medicare enrollment (or its most recent ownership change), it generally has to enroll as a new provider and undergo a fresh survey or accreditation. Exceptions apply, such as the death of the previous owner. During the moratorium, those non-exempt ownership changes are effectively off the table, which freezes most buying and selling of younger agencies.
More scrutiny, not just a freeze
The moratorium sits inside a wider program-integrity push. CMS has also rolled out enhanced enrollment screening for HHAs, including site verification and fingerprint-based background checks. It has added heightened oversight of newly enrolled hospices in higher-risk states (Arizona, California, Georgia, Nevada, Ohio and Texas) and expanded claim-review demonstrations for HHAs in several states (Florida, Illinois, North Carolina, Ohio, Oklahoma and Texas). Ohio appears on both lists, and our Ohio licensing guide explains what that means for new agencies there.
When the freeze lifts, new applications filed within six months afterward will face the highest screening level.
How to plan around the home health and hospice moratorium
The freeze is a setback if your only plan was "open a Medicare home health agency this year." But there are sensible ways forward:
- Start with what isn't frozen. You can still license and launch non-medical home care, personal care, and private-pay services in most states. Many new owners build a strong non-medical or private-pay business first, then add Medicare later. This is often the smartest entry route even without a moratorium. Our guide to launching private-pay care walks through that path.
- Get audit-ready now, so you can move the moment the door opens. When the freeze lifts, applications face the highest level of scrutiny. Agencies with airtight documentation, clean structure, and a complete compliance program will move fastest. Use this window to get ready, not to wait. If you plan to use accreditation, read why accreditation prep should start before the freeze ends.
- If you already operate, protect what you have. An existing, compliant, certified agency is now genuinely harder to replicate, which makes clean documentation and survey readiness more valuable than ever.
- Get the sequence right. The worst outcome is spending money in the wrong order. A clear roadmap for your state and service type will save you from that. Start with the licensing guide for your state on our states we support page.
Honest, fixed-price help while enrollment is frozen
This is exactly the moment where honest, fixed-price guidance pays for itself. We will tell you plainly whether your plan is viable right now, what you can launch today, and how to be first in line when Medicare enrollment reopens. Everything is delivered online, at a published price, with no surprises.
Not sure whether the home health and hospice moratorium affects your plans? Book a Discovery Call and we will map out what you can launch now and how to prepare for Medicare enrollment when it reopens. If your situation isn't a fit for us, we'll tell you who can help.
This article is general information, not legal advice, and reflects the position as of mid-2026. Moratorium dates and rules can change or be extended; we confirm the current status as part of every project.
