CMS places moratorium on new hospice, home health providers nationwide

• The moratorium is slated to last six months and will cease the establishment of new hospice and home health agencies across the country, including in Mississippi, as the agency investigates potential fraud.

As part of a larger effort to combat fraud nationwide, the Centers for Medicare and Medicaid Services has implemented a short-term moratorium on new hospice and home health agency enrollments starting this month. 

CMS said the moratoria will allow it to temporarily halt the influx of new providers into these high-risk categories—a key source of fraudulent activity.

“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” said CMS Administrator Dr. Mehmet Oz last week. “Today we’re shutting the door on fraud—preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them. This is about protecting patients, restoring integrity, and safeguarding taxpayer dollars.”

The moratorium is slated to last six months and will cease the establishment of new hospice and home health agencies across the country, including in Mississippi. 

“In Mississippi we require that hospice and home health agency providers be certified and enrolled in Medicare before they can enroll with Mississippi Medicaid. So those providers will not be able to enroll in Mississippi Medicaid during the moratoria (unless they happened to enroll in Medicare before the moratoria began),” the Mississippi Division of Medicaid said in a statement to Magnolia Tribune. 

CMS confirmed in the release that existing providers and those with current enrollments will be able to continue their work to serve Medicare recipients. 

Preventing new enrollments aims to ensure that fraudulent actions such as improper billing and other actions by “bad actors” are not taking place in what the agency calls “high-risk categories”.

As part of the moratorium, an investigation will seek to identify currently approved hospice and home health providers who may be engaging in fraudulent actives. That will include preventing those agencies from crossing state lines and CMS will deny applications for changes in majority ownership. Both are practices commonly used to avoid detection, CMS stated.

CMS has the ability to extend the moratorium for additional six month increments as the need arises.

CMS noted that recent actions undertaken in coordination with Vice President J.D. Vance’s Anti-Fraud Task Force has included the suspension of payments to approximately 800 hospices and home health agencies suspected of fraud in Los Angeles alone that were responsible for $1.4 billion in Medicare spending last year, with $70 million in suspended funds thus far.