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U.S. freezes Medicare enrollments for new home health care and hospice providers

The Trump administration will block new home health care and hospice providers from enrolling in Medicare for at least the next six months, according to a government statement posted on Wednesday, citing concerns about widespread fraud.

The moratorium will temporarily bar new providers in those categories from signing up for reimbursement from Medicare, the government health insurance program for Americans 65 and older and those with disabilities. It will not impact providers already registered with Medicare, according to the Centers for Medicare & Medicaid Services, which oversees the program.

It is the latest move by Vice President JD Vance’s anti-fraud task force that aims to crack down on health care scams.

The U.S. government has for years tried to tackle fraudulent payments from Medicare to hospice and home health care providers.

Scammers can bill Medicare for hospice or home health care services that the patient doesn’t need or want, allowing them to rake in millions of dollars from the U.S. government. The national fraud prevention group Senior Medicare Patrol has repeatedly issued alerts on the issue.

CMS has paused enrollments in the past in specific counties when staff suspected fraud, including in 2013, when it barred new providers based in Florida’s Miami-Dade County.

“This is about protecting patients, restoring integrity and safeguarding taxpayer dollars,” said CMS Administrator Mehmet Oz in a statement. 

The moratorium will give CMS time to account for hospice and home health expenditures under the Medicare program and create additional guidance, an administration official said.

In 2024, 1.8 million Medicare beneficiaries received hospice care at a cost of $28.3 billion, according to the Medicare Payment Advisory Commission. The same year, 2.7 million patients on Medicare received home health care at a cost of $16 billion, according to the agency .

Vance’s task force has recently taken action against hospice services, particularly in California, where the state auditor said in 2022 that lax oversight had enabled large-scale fraud.

Industry groups had urged different approaches as the Trump administration weighed potential action.

The National Partnership for Healthcare and Hospice Innovation said in March it supported temporarily pausing hospice provider enrollments. The National Alliance for Care at Home warned against overly broad action that could deter doctors and patients from recommending or seeking care.

Major home health operators in the U.S. include BrightSpring Health Services, private equity-backed Matrix Medical Network and UnitedHealth Group. Chemed Corp. subsidiary VITAS Healthcare is among the top hospice care providers.

Tens of billions of dollars are estimated to be lost in the United States through health care fraud each year, translating into higher costs for patients and employers, according to the National Health Care Anti-Fraud Association.

Tags business news

Reuters

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