New hospices and home health agencies still cannot enroll in Medicare. Officials extended a nationwide freeze on those enrollments for another six months, one day before the original pause was due to run out.
The extension was announced Thursday, November 12, according to Home Health Care News. A Federal Register public-inspection notice says the extension and modification of the moratorium on new Medicare hospice enrollment was effective that same day. The enrollment freezes began May 13 and had been scheduled to expire Friday, November 13. CMS is the agency running the pause.
Incumbents Get a Door Back
The first version of the freeze did more than block brand-new operators. It also stopped providers already in Medicare from adding locations, a restriction providers protested.
The modification walks that part back. Currently enrolled hospices and home health agencies may add practice locations within their existing enrollment. The extension does not affect those enrollments, and it does not stop enrolled providers from continuing to deliver services.
New applicants are still out. An agency that already has a Medicare number can grow its footprint. One that does not have a number cannot get in.
Progress, Then Another Six Months
CMS Administrator Mehmet Oz put the case for staying the course in one sentence: "We've made real progress over the past six months, but fraud in hospice and home health persists." CMS says the extra time is meant to investigate suspicious billing, strengthen safeguards and keep potentially fraudulent operators from entering Medicare.
Hospice News reported that CMS has seen "huge drops" in billing, particularly in areas described as rife with fraud. During the enrollment freeze, CMS denied 50 hospice applications and 250 home health applications.
A separate enforcement number does not belong to those six months. Arnall Golden Gregory reported that CMS revoked 1,413 providers and suppliers in the first quarter of 2026, a 40% increase and the largest quarterly increase on record. That quarter ended before the May 13 enrollment freeze began. Hospices, home health agencies and medical equipment suppliers have billed Medicare improperly more often than other provider types, and the program covers about 70 million people.
The Trump administration created an anti-fraud task force led by Vice President JD Vance, taking a more aggressive approach than prior administrations by trying to stop fraud before payment rather than chasing money afterward. Fraud experts have called enrollment pauses among the task force's most effective tactics. CMS has also rooted out pockets of fraudulent providers around the country.
A National Freeze, a Local Map
Industry groups say they support action against fraudulent providers. They also called this version too blunt.
The National Alliance for Care at Home, which says it represents more than two million professionals in home health, home care, hospice and related fields, urged CMS to let the moratoria expire on November 13. Its September argument was geographic: "Data consistently identifies fraud hotspots concentrated in specific metropolitan areas and states, not a nationwide epidemic of equivalent severity." The Alliance also said national data did not show fraud, waste or abuse so pervasive and uniform as to justify an extension across all states and territories.
The access number the Alliance put next to that argument predates the freeze. It said 38% of Medicare beneficiaries did not receive the home health services they were referred for after a hospital discharge in the third quarter of 2025. Stakeholders say the nationwide pause has since disrupted provider expansion and raised concerns about patient access, particularly in underserved communities. The Alliance says the pause has made things harder for legitimate providers.
LeadingAge, an association of nonprofit aging-service providers, asked Oz for a more targeted approach. In a September letter, president Katie Smith Sloan wrote that "it is becoming increasingly clear that legitimate providers are being caught in the crossfire of this war against fraud."
The Other Freeze Already Ended
CMS ran a separate six-month moratorium on Medicare supplier enrollment applications, the companies that supply items such as catheters and orthotic braces. That pause took effect February 27 and expired August 27, when National Provider Enrollment contractors resumed accepting initial applications, according to CMS. Nothing in that expiration says the hospice and home health rules were identical.
What it does show is that a supplier freeze was allowed to end. This one was not. For the next six months, a new hospice or home health agency still cannot enroll to bill Medicare. An agency that is already in can apply to add a practice location.
