Three national groups representing home-health agencies and hospices are asking Medicare to let its nationwide freeze on new provider enrollments expire on Nov. 13, six months after it began. LeadingAge, the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation each sent letters to CMS Administrator Dr. Mehmet Oz that became public this month, arguing that the freeze is now blocking legitimate providers from expanding into rural and underserved areas where older patients already struggle to get care after a hospital stay.
What the freeze does and when it is set to end
The Centers for Medicare & Medicaid Services announced the six-month moratoria on May 13, 2026, in coordination with Vice President JD Vance’s Anti-Fraud Task Force. The Federal Register notice for home health agencies, and a companion notice for hospices, both list May 13 as the effective date, which puts the end of the first six-month term at Nov. 13.
The freeze bars initial Medicare enrollment applications from new home health agencies and hospices, along with certain changes in majority ownership that CMS says are often used to hide who controls a business. CMS said at the outset that the moratoria “will not impact current enrollments, and existing providers can continue to deliver services to Medicare beneficiaries.” People already receiving home-health visits or hospice care from an enrolled provider keep that care; the rule governs which businesses can join the program.
Under the agency’s moratorium questions and answers, last revised July 9, a moratorium can be extended in additional six-month periods, and any extension or lifting is announced through a Federal Register notice. CMS says its rules do not allow exceptions for individual providers, and applications filed during the freeze are denied and must be resubmitted after it ends. Existing agencies also cannot add new branches or satellite offices to their enrollment while it is in place.
When a home-care referral stalls: A family waiting on an agency after a hospital discharge often ends up juggling denials, bills and prescriptions at once, and the prior-authorization appeal steps and the medication and cost tracker keep that paperwork in one place in The Medicare Cost & Coverage Protection Kit.
Why industry groups now want it lifted
The pushback is notable because several of the same groups backed the freeze when it started. LeadingAge, a Washington-based association of about 5,300 nonprofit aging-services providers, originally called the moratorium a tool to give CMS time to develop a longer-term fix. In a Sept. 9 letter to Oz, LeadingAge President and CEO Katie Sloan wrote that “legitimate providers are being caught in the crossfire of this war against fraud,” Home Health Care News reported.
Sloan said the national scope “does not allow exceptions to enrollments in areas with clear needs” and that members who had invested in new hospice or home-health services had been delayed. Mollie Gurian, LeadingAge’s vice president of policy and government affairs, told Hospice News that members planning to open in underserved areas, or to add offices near patients they already serve, have been held back.
The National Alliance for Care at Home, which represents more than two million home-health, home-care and hospice professionals, told CMS that fraud is concentrated in particular metropolitan areas and states rather than spread evenly across the country. “National data does not demonstrate that fraud, waste or abuse in home health or hospice is so pervasive and geographically uniform as to warrant an extension of the enrollment moratoria across all 50 states and territories,” Alliance CEO Jennifer Sheets wrote.
The National Partnership for Healthcare and Hospice Innovation, which also supported the freeze in May, told Oz and CMS Chief Operating Officer Kim Brandt that it has “accomplished its intended purpose.” The group proposed a Hospice Program Integrity Task Force and said it would support future moratoriums only if they were aimed at specific places, provider types or risk factors.
What the access numbers show for older patients
The Alliance letter leaned on data about patients leaving the hospital. Through the third quarter of 2025, 38% of Medicare beneficiaries who were referred for home health care at discharge never received it, according to the letter as reported by Hospice News. Patients who went without that care had a 36% higher 90-day death rate and a 33% higher hospital readmission rate than those who received it, and rural beneficiaries faced a wider gap.
The Alliance acknowledged that the freeze did not create that gap. Its argument is that established agencies with strong quality records have been asked by communities to extend services and cannot do so while new locations and new enrollments are blocked. The group also said health systems have delayed or dropped home-health partnerships, and that some hospices that built inpatient units are paying leases on space they cannot open.
For a retiree or family caregiver, the practical effect is indirect but real. The freeze does not cancel anyone’s Medicare home-health or hospice benefit, which still depends on a doctor’s order and the program’s coverage rules. It can, however, limit how many agencies are available to accept a referral in a given area, particularly outside large cities.
What CMS says it is doing about fraud
CMS has framed the moratoria as one part of a broader crackdown. In its May announcement, the agency said it had suspended payments to about 800 hospices and home health agencies in Los Angeles suspected of fraud, providers that accounted for $1.4 billion in Medicare spending the previous year, with $70 million in suspended funds at that point. It also cited heightened oversight of newly enrolled hospices in Arizona, California, Georgia, Nevada, Ohio and Texas, fingerprint-based background checks for high-risk home health agencies and expanded pre- and post-claim review of home-health claims in six states.
“Today we’re shutting the door on fraud,” Oz said at the time. CMS has used extensions before; its questions-and-answers document notes that the agency imposed and extended a series of state and local home-health and ambulance moratoria between 2013 and 2018. It has not said publicly whether it will renew the current freeze.
Whatever CMS decides, the agency says an extension or the lifting of a moratorium is announced through a Federal Register notice. Beneficiaries can check the agencies and hospices serving their area, along with quality ratings, on Medicare’s Care Compare tool, and can ask a hospital discharge planner for a list of enrolled agencies that are accepting new patients.
Fewer agencies can mean more follow-up for families
If fewer providers can take a referral, the burden shifts to the household: tracking which agency said yes, what Medicare approved and what the next prescription or bill will cost.
The Medicare Cost & Coverage Protection Kit includes the prior-authorization appeal steps, 51 state Medicare cost-help packs and a medication and cost tracker, which together cover the denials, state help programs and running costs that pile up around a care transition.
Start with the state cost-help pack for the right state in The Medicare Cost & Coverage Protection Kit.
This article was prepared with AI assistance and reviewed against the linked official sources.
