CMS extends the home health and hospice enrollment moratorium for six months, but lets enrolled agencies add branches and locations again

Short answer: Yes, the freeze continues. In notices filed Nov. 12 for Nov. 16 publication, CMS extended the nationwide Medicare enrollment moratoria on new home health agencies and new hospices for another six months, effective Nov. 12, 2026. It also narrowed both: enrolled agencies may again add HHA branches, and enrolled hospices may add practice locations.

Key facts (as of Nov. 12, 2026, about 4:15 p.m. CT) - The notices: FR Doc. 2026-23241 (CMS-6101-N2, home health agencies) and FR Doc. 2026-23242 (CMS-6102-N2, hospices) went on public inspection Nov. 12 at 4:15 p.m. ET. Both are scheduled to publish in the Federal Register on Monday, Nov. 16. - Effective: Nov. 12, 2026, for another 6-month period, per each notice's "Dates" line. - Still frozen: initially enrolling HHAs and hospices, including those enrolling through a non-exempt change in majority ownership (CIMO) under 42 CFR 424.550(b). - No longer frozen: branch additions by enrolled HHAs, and new practice locations for enrolled hospices. - Illinois: not among the states CMS names as running their own Medicaid moratoria.

What did CMS announce on Nov. 12?

CMS filed two notices with the Office of the Federal Register on Thursday afternoon, the day before the six-month mark of the freezes that began May 13. The home health notice "announces the extension and modification of the nationwide temporary moratorium on the enrollment of new Medicare Home Health Agencies." The hospice notice does the same for hospices.

Both say: "The extension and modification of the moratorium is effective" Nov. 12, 2026. They are on public inspection now and are scheduled for formal publication Nov. 16. That is the step 42 CFR 424.570(b) requires: an extension in a 6-month increment, announced by a Federal Register document. The hospice notice says it "fulfills" that requirement.

What is still frozen?

New enrollments. The home health notice says the extension "will only apply to initially enrolling HHAs (including those initially enrolling pursuant to a non-exempt CIMO under § 424.550(b))." The hospice notice uses the same words for hospices.

Under 42 CFR 424.530(a)(10) and 424.570(c), CMS denies an enrollment application from a provider subject to a moratorium. The notices say an application fee is refunded if the application is denied because of the moratorium, and that an appeal under 42 CFR part 498 is limited to whether the moratorium applies to the appellant. There is no judicial review of the decision to impose a moratorium.

The regulation's existing exceptions are restated: the freeze does not apply to most changes in practice location, changes in information such as a phone number or address, most changes in ownership other than majority-ownership changes that require initial enrollment, or applications the Medicare contractor received before the moratorium was imposed.

What changed for agencies already enrolled?

The May freezes covered new HHAs and HHA branches (91 FR 27954) and new hospices and hospice practice locations (91 FR 27946). The extension drops the second half of each.

The home health notice says the extension "will not apply to additions of HHA branches, and the moratorium on the addition of branches by currently enrolled HHAs will end as of the effective date of this notice." The hospice notice says the same about "additions of hospice practice locations."

CMS's stated reason is "greater concern at this current time about new HHAs – with whom we may have no experience" than about enrolled agencies adding a branch, "though the latter are still of concern to us." The hospice notice gives the same reason.

Why did CMS extend the freeze?

CMS says "the circumstances warranting the imposition" of each moratorium "have not yet abated." Both notices say the HHS Office of Inspector General was consulted and agreed there is still a significant potential for fraud, waste or abuse.

The home health notice cites an Aug. 13, 2026, Justice Department enforcement memorandum and 2026 federal cases in Michigan, Missouri, Florida and California. The hospice notice cites 2026 California hospice fraud cases and a June 3, 2026, FBI public service announcement on hospice fraud. In the home health notice, CMS says it considered letting the freeze expire and considered limiting it to southern California, and rejected both because it views the problem as nationwide.

On access, both notices say CMS has not seen evidence the May moratoria materially reduced Medicare beneficiaries' access to home health or hospice services nationally or in any state. CMS says it will keep monitoring, particularly in rural areas.

What about Medicaid and state moratoria?

CMS again leaves Medicaid and CHIP moratoria to each state. It says Ohio and Rhode Island put in home health moratoria after the May notices, and Louisiana, Nevada, Ohio, Pennsylvania and Rhode Island put in hospice moratoria. The extension "is not intended to impact these existing moratoria." Illinois is not named in either list.

When does the extension end?

Neither notice prints a calendar end date. Six months from Nov. 12 is about May 12, 2027, by our arithmetic. Under 42 CFR 424.570, CMS may extend again in another 6-month step or lift the freeze early, and either would be announced in the Federal Register.

As of about 4:10 p.m. CT Thursday, CMS's Provider Enrollment Moratoria page still described only the May 13 freeze and showed a last-modified date of Aug. 27, 2026. We will update this story after the Nov. 16 publication. Our moratorium tracker and explainer on what the rule says have background; the separate changes to 424.570 in the CY 2027 home health rule are in our CMS-1844-F story.

What this page is not

Not clinically reviewed. Not billing, enrollment or legal advice. Agencies weighing an application, branch or practice-location filing should read the notices and check with their Medicare Administrative Contractor.

Sources

• Federal Register public inspection, FR Doc. 2026-23241 (CMS-6101-N2, HHA extension), filed Nov. 12, 2026 (PDF)
• Federal Register public inspection, FR Doc. 2026-23242 (CMS-6102-N2, hospice extension), filed Nov. 12, 2026 (PDF)
• eCFR, 42 CFR 424.570
• Federal Register, FR Doc. 2026-09717 (HHA moratorium), May 15, 2026
• Federal Register, FR Doc. 2026-09718 (hospice moratorium), May 15, 2026
• CMS, Provider Enrollment Moratoria

Photo: Carol M. Highsmith, Library of Congress, via Wikimedia Commons, public domain (cropped). "Homage to Medicare and Medicaid" in the lobby of the CMS headquarters building in Woodlawn, Md., Dec. 18, 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.