The CMS is halting new hospice and home health agency enrollment in Medicare for six months as part of the Trump administration’s move to crack down on healthcare fraud.
During the pause, the CMS will increase targeted investigations of hospices and home health providers, roll out advanced analytics of enrollment data and indicators of fraud, waste and abuse, and more quickly remove providers suspected of fraud from the Medicare program.
The moratorium applies to applications for new Medicare enrollment, as well as some changes to majority ownership. Current enrollments and existing providers won’t be impacted, the agency said.
“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,” CMS Administrator Dr. Mehmet Oz said in a statement Wednesday. “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.”
Home health and hospice groups support the Trump administration’s move to crack down on fraud, noting bad actors “undermine public trust” and take advantage of vulnerable patients, Tom Koutsoumpas, founder and CEO of the National Partnership for Healthcare and Hospice Innovation, said in a statement.
However, an enrollment suspension that doesn’t distinguish between fraudulent and legitimate providers could reduce competition in the sector and increase wait times for care in rural and underserved areas, the National Alliance for Care at Home said in a statement.
“CMS must use data-driven, risk-based program integrity measures and focus resources on boots-on-the-ground surveys and enforcement of existing oversight mechanisms that root out the blatantly bad actors without potentially limiting patient access to care or punishing high quality providers operating in good faith,” said Jennifer Sheets, the alliance’s CEO.
The Trump administration says risk of fraud in hospices, which provide care to terminally ill patients, has increased significantly in recent years. The CMS says more hospices are certifying patients for care when they weren’t near death or paying recruiters to find beneficiaries who weren’t eligible in order to receive reimbursement from the government.
Additionally, the agency says the number of hospices has exploded in some states like Arizona, California, Nevada and Texas at a faster rate than that of hospice beneficiaries. For example, the number of Medicare enrolled hospices increased 151% in Nevada from 2019 to 2023, while spiking 126% in California during the same period.
Home health agencies, which deliver skilled nursing or other care in patients’ homes, are also being targeted in the fraud crackdown. The industry has been a “severe problem” for more than two decades, given the low costs to start home health agencies and limited supervision of providers working in homes, the CMS said.
The number of agencies has also spiked in some regions, including Los Angeles County, where the provider count increased by over 40% from 2019 to 2024, according to the CMS.
The moratorium comes as the Trump administration has targeted what is says is fraud in federal healthcare programs. In February, the agency imposed a six-month moratorium on Medicare enrollment for certain suppliers of durable medical equipment, prosthetics and orthotics, citing longstanding waste fraud and abuse.
The CMS is also investigating state Medicaid programs. Earlier this year, the agency withheld around $250 million in Medicaid funds to Minnesota over unsupported or potentially fraudulent claims, and last month said it would defer an additional $91 million.
Critics have argued the Trump administration is disproportionately targeting Democrat-led states, including New York, California and Maine. Late last month, Oz said the Medicaid fraud crackdown would expand to all 50 states, requiring them to submit plans on how they revalidate Medicaid providers.
