As communicated first in a LeadingAge Ohio “Action Alert” last week, CMS announced a six-month nationwide moratorium on new Medicare enrollments for hospice and home health providers effective May 13. This marks the most significant federal fraud enforcement action the industry has seen in years.
The moratorium is part of a broader federal anti-fraud initiative focused on hospice and home health program integrity, ownership transparency, billing practices, and provider enrollment oversight. Existing Medicare-certified providers may continue operating and serving patients without interruption.
The announcement came during a White House press conference featuring Vice President JD Vance, CMS Administrator Dr. Mehmet Oz, and federal anti-fraud leadership. In addition to the moratorium, federal officials announced expanded Medicaid fraud oversight initiatives and continued payment suspensions tied to suspected fraud activity.
Ohio is already familiar with heightened scrutiny. Hospice providers in the state remain under expanded oversight initiatives, including prepayment review and enhanced enrollment oversight. Following the federal announcement, Governor Mike DeWine also announced several new Ohio Medicaid fraud prevention initiatives, including efforts tied to provider enrollment, electronic visit verification (EVV), and expanded data analytics to identify high-risk billing patterns.
At the same time, providers and national organizations are urging regulators to ensure enforcement efforts remain targeted. Industry leaders have raised concerns that legitimate providers may be getting caught in broader enforcement activity, including payment suspensions tied to live discharge patterns and utilization reviews.
CMS also clarified that hospices may continue using telehealth for face-to-face recertifications during the moratorium period, despite questions raised following recent federal legislation.
Why it matters
This moves federal oversight beyond discussion and into active nationwide intervention.
For hospice and home health providers, the environment is shifting rapidly toward:
Even compliant providers may experience operational ripple effects, including additional ADRs, referral hesitancy, and increased documentation demands.
What to do