What You Need to Know About CMS’s New Home Health & Hospice Enrollment Moratorium

Today, the Centers for Medicare & Medicaid Services (CMS) announced a major nationwide enforcement action that is already sending shockwaves through the home health and hospice industries. CMS will implement a six-month nationwide moratorium on new Medicare enrollments for home health agencies (HHAs) and hospice providers as part of a broader federal anti-fraud initiative. (cms.gov)

For Indiana eldercare professionals, the announcement arrives during an already turbulent period for the state’s home-based care industry.

The federal action comes on the heels of recent allegations involving five Indiana personal services agencies accused in a Medicaid fraud scheme reportedly totaling more than $200 million. Those allegations have intensified statewide conversations surrounding compliance, oversight, billing integrity, and accountability across aging services and Medicaid-funded care programs.

At the same time, Indiana providers are still navigating the long-term impact of major state-level policy changes implemented over the last several years regarding Medicaid participation and Medicare certification requirements for home health agencies.

In recent years, Indiana announced changes requiring home health agencies serving Medicaid participants to also become Medicare-certified providers. While the policy was intended to strengthen oversight and standardization, many providers across the state reported that the transition created significant operational and financial strain.

For smaller agencies especially, obtaining Medicare certification required navigating:

• Extensive regulatory requirements

• Costly accreditation processes

• Increased administrative burdens

• Complex compliance standards

• Staffing and clinical oversight challenges

• Long approval and survey timelines

As a result, many non-medical home care and personal services agencies began exploring or transitioning into the home health model out of concern they could lose access to Medicaid programs or future reimbursement opportunities if they did not adapt.

Throughout Indiana’s healthcare community, many operators described the environment as one driven by uncertainty and fear of being left behind in an increasingly regulated system.

For some organizations, the transition to home health was strategic and well-planned. For others, however, the rapid push toward Medicare certification created confusion, financial pressure, and significant barriers to entry — particularly for smaller community-based providers attempting to continue serving seniors and individuals with disabilities.

Now, with CMS announcing a nationwide moratorium on new Medicare enrollments for home health agencies and hospices, many Indiana providers are once again facing uncertainty about what comes next.

According to CMS, the new moratorium is intended to temporarily halt enrollment of new Medicare hospice and home health providers while investigators intensify fraud prevention efforts, audits, and enforcement activities nationwide. CMS Administrator Dr. Mehmet Oz stated the agency has identified “systemic and deeply troubling fraud” involving some organizations operating within these sectors. (cms.gov)

Importantly, the moratorium does not affect currently enrolled Medicare providers. Existing Indiana home health and hospice agencies may continue operating and serving patients without interruption. However, the announcement could significantly affect:

• Organizations currently pursuing Medicare certification

• Entrepreneurs planning to launch new Indiana HHAs or hospice agencies

• Pending ownership changes or acquisitions

• Expansion plans involving additional Medicare enrollments

• Providers who were transitioning from personal services or non-medical home care into the home health space

Federal notices indicate the moratorium became effective May 13, 2026, and could potentially be extended if CMS determines additional enforcement action is necessary. (public-inspection.federalregister.gov)

For many Indiana eldercare professionals, there is broad support for identifying and removing bad actors who exploit vulnerable populations and misuse taxpayer dollars. However, there is also concern that broad enforcement actions and regulatory crackdowns may unintentionally create additional obstacles for ethical providers who are genuinely working to expand access to quality care throughout Indiana.

Indiana continues to face growing demand for:

• In-home care services

• Dementia and Alzheimer’s support

• Chronic disease management

• Workforce development

• Community-based alternatives to institutional care

• Aging-in-place support systems

As demand continues to rise, many providers worry prolonged enrollment freezes and heightened scrutiny could slow service expansion, delay startup timelines, and further limit access to care in underserved communities.

At this stage, many operational questions remain unanswered, including:

• How pending Medicare applications will be handled

• Whether exceptions or hardship provisions may exist

• How ownership changes will be reviewed

• What additional screening and compliance measures may follow nationwide

• How these changes could affect Indiana agencies currently attempting to transition into Medicare-certified home health operations

Our association is actively monitoring this rapidly evolving situation and reviewing guidance from CMS and the Indiana Department of Health to better understand how these developments may impact Indiana providers both now and in the months ahead.

We encourage Indiana eldercare professionals, agency owners, administrators, consultants, and aspiring providers to remain informed, prioritize strong compliance practices, and closely monitor federal and state updates as additional clarification becomes available.

We will continue providing timely updates, education, advocacy, and professional resources to support Indiana’s eldercare community through these rapidly changing regulatory and compliance developments.

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