On May 13, 2026, the Centers for Medicare & Medicaid Services (“CMS”), in coordination with Vice President JD Vance’s Anti-Fraud Task Force, announced a six-month, nationwide moratorium on new Medicare enrollment for hospices and home health agencies (“HHAs”), effective immediately.
In its press release, CMS stated that the moratorium is “part of CMS’ ongoing efforts to stop fraud before it starts, using data-driven prevention and real-time enforcement as part of a coordinated federal approach.” During the moratorium, CMS intends to “intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud.”
The announcement follows an increased focus and emphasis on combatting fraud by CMS and other agencies, including, for example, the suspension of payments to approximately 800 hospices and HHAs accused of fraud in Los Angeles. CMS also recently withheld more than $250 million in Medicaid reimbursement to Minnesota for alleged fraud.
On May 15, 2026, CMS also issued notices in the Federal Register announcing the moratorium. According to the notices, the agency adopted this measure pursuant to authority granted under the Affordable Care Act, which permits CMS to temporarily suspend the enrollment of new providers or supplier types where it determines that such action is necessary to prevent or combat fraud, waste, or abuse in federal healthcare programs.
CMS explained that it has detected increasing risks of fraud within the hospice industry for several years, observing instances of hospices certifying patients for hospice care when they were not terminally ill and providing little to no services to beneficiaries. CMS also cited the rapid growth in potentially fraudulent hospices in certain areas, among other problems. The agency pointed to numerous recent criminal cases involving fraudulent conduct within hospices, such as the 2025 sentencing of several California residents for their roles in defrauding Medicare of nearly $16 million through sham hospice companies and laundering the fraudulent proceeds.
In light of these findings, CMS determined that existing program-integrity tools—such as enhanced screening, enrollment requirements, and post-payment review—were insufficient on their own to prevent fraudulent actors from entering the Medicare program. It emphasized that these tools largely operate after enrollment has occurred, whereas the moratorium is intended to address what CMS describes as a “front-end” vulnerability in the enrollment process.
Given this development, our expectation is that CMS and DOJ will use the moratorium period to expand investigative activity, which could serve as a precursor not only to additional criminal prosecutions but also to increased civil False Claims Act (“FCA”) enforcement. Additionally, we would anticipate the moratorium may result in changing guidance or new, stricter interpretations from CMS that could impact hospice providers, including how the government could pursue alleged fraud going forward.
WilmerHale will continue to monitor activity by CMS, HHS-OIG, and DOJ during the moratorium and stands ready to assist clients in investigations and enforcement actions brought against them. In particular, our FCA practice group has extensive experience representing healthcare providers in non-public FCA and HHS-OIG investigations.
