CMS Enforces New Enrollment Moratorium on Home Health and Hospice Agencies

The Centers for Medicare and Medicaid Services (CMS) has officially implemented a six-month, nationwide moratorium on new Medicare enrollments for hospice and home health providers. This measure, supported by the Anti-Fraud Task Force, is designed to curb systemic billing fraud and protect the integrity of the Medicare program by halting the entry of high-risk entities into the sector.

Key takeaways

• A six-month moratorium is now in effect for all new Medicare enrollment applications.

• The freeze extends to specific changes in majority ownership, which are frequently used to obscure control by fraudulent actors.

• Existing, compliant providers remain unaffected and may continue to deliver care to Medicare beneficiaries.

• CMS is utilizing advanced data analytics to target and investigate suspected fraudulent billing practices across the hospice and home health industries.

Understanding the scope of the moratorium

The implementation of this moratorium signals a significant shift in CMS oversight. As a CPA firm with over 25 years of experience serving the home health and hospice industries in Chicagoland, Soriaga and Associates understands that regulatory changes demand heightened scrutiny of financial and administrative operations. The current focus on fraud prevention means that maintaining transparent, audit-ready records is more critical than ever. Whether your agency is in Naperville, Lisle, or Westmont, ensuring your operational compliance remains the best defense against evolving federal oversight strategies.

Impact on established providers

It is important to note that the current action does not impact the service delivery of established home health and hospice agencies. Current providers who remain in good standing should view this period as an opportunity to reinforce their financial accuracy and operational efficiency. By leveraging precise bookkeeping, payroll management, and rigorous cost report preparation, organizations can demonstrate their legitimacy to federal authorities. At Soriaga and Associates, our fractional CFO services and specialized consulting are tailored to help small healthcare businesses navigate these complex regulatory environments, ensuring that your financial foundation is prepared for any level of administrative review.

Maintaining long-term compliance

As the industry faces increased scrutiny, the focus on 'bad actors' underscores the necessity for legitimate providers to distinguish themselves through professional financial management. Fraud investigation efforts, including the recent suspension of payments in high-risk zones, highlight the importance of diligent accounting. Properly managing your company's ownership structures and financial disclosures is no longer just a best practice—it is essential for long-term viability. Our team provides the targeted support necessary to keep your agency’s accounts compliant and accurate, allowing you to focus on your core mission: providing high-quality care to patients in your community.

Sources

• CMS issues moratorium on hospice and home health agency enrollment, Healthcare Finance News.