Hospice, Home Health Moratoria: What Might Come Next

CMS's six-month nationwide moratoria on hospice and home health Medicare enrollment are set to expire November 13, leaving providers uncertain about growth even as CMS has not indicated whether they will be extended, according to Hospice News.

The moratoria prohibit applications for new Medicare enrollment for hospices and home health agencies and apply to certain changes in majority ownership. They have prevented many operators from expanding through de novos, disrupted acquisitions and affiliations, and left some smaller providers hoping to sell "stuck," including owners planning retirement or relocation.

Industry attorneys said Medicare Administrative Contractors (MACs) are disregarding the dates enrollment applications were submitted and denying them even when filed before the moratoria began. "We have a lot of hospice clients whose business plans involved expansion... to a large extent, that's put on hold," Rachel Hold-Weiss, healthcare partner at Benesch, told Hospice News.

Lanchi Bombalier, partner at Arnall Golden Gregory, said the moratoria left a lot of uncertainty around transactions, delaying deals for committed providers that had not yet hit their filing deadline and chilling the industry.

Stakeholders have called on CMS to implement more targeted moratoria focused on markets where fraud has been prevalent, while state governments may establish their own moratoria or other restrictions, adding further hurdles in some regions. Providers should prepare for both extension and expiration scenarios.