If you were planning to open a Medicare-certified home health agency or hospice in the United States right now, you need to read this first. On 13 May 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. It 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 moratorium does
The moratorium applies across every state and US territory. It runs for an initial six months — through approximately 13 November 2026 — and CMS can extend it in further six-month blocks.
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 13 May 2026),
- new branch locations opened by existing providers,
- most changes of majority ownership that would trigger a new enrollment under the "36-month rule" (more on that below), and
- expansion of an existing agency's approved service area into new territory.
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 13 May 2026 keep moving. If your enrollment was already in the pipeline, it continues to be processed. (If this is you, confirm and keep proof of the date your application was received.)
- 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.
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 — unless an exception applies, such as the death of the previous owner. During the moratorium, those non-exempt ownership changes are effectively blocked, 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 — 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). And when the freeze lifts, new applications filed within six months afterward will face the highest screening level.
So what should you do?
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. Non-medical home care, personal care, and private-pay services can still be licensed and launched 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.
- 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 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.
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 — all online, at a published price, with no surprises.
Not sure whether the freeze 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.
