2026 Hospice and Home Health Enrollment Moratorium: Transaction Risks Before November

The moratorium is active—and it reaches beyond new startups

CMS imposed a six-month nationwide Medicare enrollment moratorium for new home health agencies (HHAs) and hospices effective May 13, 2026. As of October 16, the agency continues to describe those moratoria as active. The immediate consequence is not simply that a newly formed agency cannot obtain initial enrollment. CMS also identifies certain non-exempt changes in majority ownership under 42 C.F.R. § 424.550(b) as applications affected by the restriction. Owners, buyers, lenders and transaction advisers should assess enrollment consequences before signing or closing a deal. Transaction planning should also consider PECOS ownership, location, and enrollment reporting deadlines.

The transaction structure matters

A stock purchase, asset purchase, merger, change of control or new practice-location plan can have materially different enrollment implications. A state-law transfer that appears straightforward may create a separate federal enrollment question. The party planning the transaction should identify which Medicare provider number is involved, the enrolled legal entity, the actual ownership before and after closing, the date the enrollment application would be received, and whether the proposed change falls within a regulatory exception. Treating a transaction label as the answer is risky.

In its published moratorium guidance, CMS states that initial applications—including non-exempt changes in majority ownership—submitted after implementation will be denied. That is a reason to perform enrollment diligence early, not a conclusion that every pending sale is prohibited. Eligibility, application timing and exceptions are fact-specific.

Do existing hospices and home health agencies stop billing?

No. The announcement concerns specified enrollment applications, not a blanket cancellation of billing privileges for every already-enrolled hospice or HHA. Existing providers remain responsible for satisfying applicable Medicare enrollment, survey, quality and claims requirements. A provider facing a separate revocation, deactivation, payment suspension or survey action needs to evaluate that notice on its own terms.

A five-part diligence review

First, map the ownership chain, management agreements and related entities rather than examining only the named seller and buyer. Second, obtain current enrollment information and identify pending revalidations, changes of information and location additions. Third, evaluate whether a change in majority ownership or another initial enrollment event may be triggered. Fourth, build closing conditions around a defensible regulatory determination and the correct application timeline. Fifth, allocate risk in the purchase agreement: who bears delay, lost billing, denial, termination expenses and any required restructuring?

A commercial term sheet should not assume that licensure, state transaction approvals and federal Medicare enrollment are interchangeable. They are separate questions. Counsel may need to coordinate with enrollment specialists and regulatory personnel before a deal becomes irreversible.

What happens after the initial six months?

The May 13 effective date makes the initial six-month period an important November 2026 planning milestone, but it does not guarantee that applications become available on a particular November date. CMS has stated that a moratorium may be extended in six-month increments. Deal teams should verify CMS’s current notice and any Federal Register action immediately before submission or closing. Do not rely solely on an estimated expiration date inserted into a contract months earlier.

Questions to resolve before spending on a transaction

Is the entity already enrolled? Are the proposed owners or managing organizations changing? Does the transaction require a new application, a change of information, or a change in majority ownership? Has any application already been submitted and acknowledged? Are there Medicaid participation or state licensing consequences? What does the purchase agreement say if Medicare enrollment cannot proceed on schedule? These questions are often cheaper to address in diligence than in a post-closing dispute.

BOLO Health Law advises healthcare owners and regulated businesses about enrollment, healthcare practice transactions and federal program-integrity exposure. See our healthcare transactions practice and enrollment defense services, or contact the firm to discuss a specific proposed transaction.

Primary sources

CMS: Provider Enrollment Moratoria; Federal Register: HHA Moratorium; Federal Register: Hospice Moratorium.

General legal information as of October 16, 2026, not legal advice. The status and scope of federal programs may change. No attorney-client relationship is created by reading this article. BOLO Health Law is a New Jersey law firm; representation is subject to jurisdiction, conflicts and engagement terms.