The published CY 2027 home health rule rewrites how Medicare enrollment moratoria work: what 42 CFR 424.570 now says

Short answer: CMS-1844-F, published Nov. 9, 2026, at 91 FR 72022, finalizes without modification changes to 42 CFR 424.570. A future moratorium will take effect on the date its notice is filed for public inspection, and reactivations, re-enrollments after a revocation bar and certain ownership changes count as new applications. The rule does not extend the current HHA and hospice freezes.

Key facts (as of Nov. 9, 2026, morning) - Published: FR Doc. 2026-22750, 91 FR 72022–72173, Monday, Nov. 9 (official PDF). - Moratorium rule: CMS is "finalizing our proposed changes to § 424.570 without modification." - Start date: a moratorium now takes effect when its notice is filed for public inspection at the Office of the Federal Register, not when it is published. - What counts as "new": initial enrollments, ownership changes that require initial enrollment, re-enrollment after a reenrollment bar, reactivations, and re-enrollment after voluntary termination. - Precedent in the rule: February's DMEPOS medical-supply moratorium "expired on August 27, 2026, and was not extended." - Not in the rule: an extension or lift of the HHA and hospice moratoria in effect since May 13.

This is the published Federal Register text. Earlier coverage, including our Nov. 6 enrollment-changes story, relied on the public-inspection copy. That story did not cover the moratorium section.

What did CMS finalize for 42 CFR 424.570?

Section V.C.4 of the preamble, "Temporary Moratoria (§ 424.570)," describes three changes. After summarizing comments, CMS writes that it is "finalizing our proposed changes to § 424.570 without modification." The amended regulation text at the end of the rule makes these changes:

• Effective date. The old paragraph (a)(1)(iv) becomes (a)(1)(iv)(A): a moratorium "does not apply to any enrollment application that has been received by the Medicare contractor prior to the date the moratorium is imposed." New (a)(1)(iv)(B) says the date a moratorium is imposed "is the moratorium's effective date, which is the date on which the moratorium notice is filed for public inspection at the Office of the Federal Register (OFR)."
• What "new" means. Paragraph (a)(1)(i) now lists five application types that, "solely for purposes of this section," are "new" and covered by a moratorium. They are initial enrollment applications; change of ownership applications that require an initial enrollment; applications from revoked providers whose reenrollment bars under 424.535(c) have expired; reactivation applications; and applications from voluntarily terminated providers or suppliers seeking to enroll again.
• Ownership changes. The exception for ownership changes in (a)(1)(iii)(C) now excludes "changes in ownership that require an initial enrollment, such as, but not limited to, an HHA, hospice, or DMEPOS supplier change in majority ownership under §§ 424.550(b) or § 424.551." CMS says this codifies existing policy that hospices and DMEPOS suppliers going through a non-exempt change in majority ownership must enroll as new and are subject to a moratorium, as HHAs already were.

Why does CMS want the filing date, not the publication date?

CMS's stated reason is the gap between public inspection and publication. If the publication date controlled, the rule says, "the affected providers/suppliers might have several days to submit their initial applications in order to 'beat the deadline.'"

Commenters argued for the publication date. They said providers may not get enough notice when a document is only on display, and that a later date would be fairer. CMS replied that newly displayed documents are as public as published ones. It added that "we cannot afford to assume that no providers will be able to submit applications during this period."

Why are reactivations covered?

Commenters said deactivations can happen for minor reasons, such as six months without billing Medicare, and that a reactivating provider is not "new." CMS disagreed. It says a deactivated provider's billing is halted and its participation "blocked in a manner akin to a revocation," and it kept reactivations in the definition. CMS also wrote that it does "not foresee beneficiary access issues arising from revised § 424.570 based on our past experience with moratoria." CMS likewise rejected requests to exempt low-risk changes in majority ownership. It said case-by-case exceptions are not something section 1866(j)(7) of the Social Security Act permits.

When do these changes take effect?

The rule's DATES section reads, as printed: "With the exception of the HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245, these regulations are effective on January 4, 2026. The HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245 are effective January 1, 2027."

The 424.570 changes fall in the first group. The printed "January 4, 2026" comes before the Nov. 9, 2026, publication date. We are quoting it exactly as printed. As of Monday morning we found no correction notice for this document in the Federal Register, and we are not substituting a date of our own. The eCFR text of 424.570 which eCFR listed as up to date as of Nov. 5, did not yet show the amendments when we opened it Monday.

Does this rule extend the HHA and hospice moratoria?

No. The rule notes that "as of May 13, 2026—there are national moratoria on the enrollment of new HHAs and hospices." It adds that "all moratoria (including a moratorium extension) are announced via a notice published in the Federal Register." The rule is not such a notice.

It also records a recent precedent. In a footnote, CMS says it imposed a nationwide moratorium on DMEPOS medical supply companies in a notice displayed Feb. 25 and published Feb. 27, 2026 (91 FR 9855). That moratorium "expired on August 27, 2026, and was not extended." That is a statement about the DMEPOS freeze only. It is not a statement about what CMS will do with the HHA and hospice freezes.

As of Monday morning, Nov. 9: a Federal Register documents API search for CMS documents matching "moratorium" or "moratoria" published since Oct. 25 returned one result, this final rule. About Nov. 13 is six months from the May 13 effective date by our arithmetic; the May notices do not print an end date. Our explainer on what 42 CFR 424.570 says if the freeze is not extended and the running moratorium tracker cover that clock. The new filing-date provision defines when a moratorium is "imposed." The rule does not say how it would apply to an extension of the current freezes, and we are not predicting.

What else in CMS-1844-F should agencies read?

The payment side of the rule is covered in our CY 2027 final-rule explainer and the Nov. 9 checklist. The other enrollment changes are in our Nov. 6 story. They include new denial and revocation grounds, hospice medical director limits, and a separate change to 424.540(b)(3)(i) that requires reactivating hospices to undergo a state survey or accreditation first.

What this page is not

Not clinically reviewed. Not billing, coding or legal advice. Not a prediction that CMS will or will not extend the HHA and hospice moratoria. Not a correction of the rule's printed effective date.

Sources

• Federal Register, CMS-1844-F, FR Doc. 2026-22750, 91 FR 72022, Nov. 9, 2026
• GovInfo, official PDF of FR Doc. 2026-22750
• eCFR, 42 CFR 424.570 (current text)
• Federal Register documents API, CMS moratorium search since Oct. 25

Photo: Carol M. Highsmith, Library of Congress, via Wikimedia Commons, public domain (cropped). The CMS headquarters building in Woodlawn, Maryland, December 2007. File photo; illustration only.

Not clinically reviewed. Informational only, not billing, legal or clinical advice. Check the linked primary source and your Medicare Administrative Contractor.

Drafted with AI assistance from primary sources. Written and edited by the Home Health Brief newsroom under Monsaur Othman's editorial standards. Read how we use AI, our editorial policy and our corrections policy.