Trump administration pauses new hospice and home health providers’ enrollment in Medicare
Trump administration pauses new hospice and home – The Centers for Medicare and Medicaid Services (CMS) unveiled a six-month pause on enrolling new hospice and home health providers into the Medicare program on Wednesday, marking another step in the administration’s campaign to address alleged fraud. This move, which comes amid heightened scrutiny of healthcare providers, aims to curb the entry of entities suspected of exploiting the system for financial gain.
Targeting Fraud in Medicare
Dr. Mehmet Oz, the CMS administrator, emphasized the gravity of the situation in a statement, stating that the agency has observed “systemic and deeply troubling fraud” within hospice and home health sectors. According to Oz, these fraudulent activities have led to the misappropriation of taxpayer funds, with bad actors preying on vulnerable patients. “Today, we are sealing off the door to new fraudulent actors while intensifying our efforts to uncover, investigate, and eliminate those already operating within the system,” he explained.
We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer.
Oz’s actions align with the initiatives of Vice President JD Vance’s Anti-Fraud Task Force, which has been central to the administration’s strategy. The pair is set to unveil additional measures related to fraud detection later that day. Vance’s visit to Maine on Thursday is part of a broader effort to highlight the state’s role in the ongoing anti-fraud campaign, which has already drawn significant attention.
Maine, a state currently in the spotlight for its Medicaid program, is expected to host one of the most competitive Senate races in the November midterms. GOP Senator Susan Collins, seeking a sixth term, faces a challenging campaign. Trump officials have previously pointed to Maine as a hub of fraudulent activities, a claim that has intensified with the recent focus on the state’s programs.
Alongside the moratorium, CMS has taken other steps to tighten oversight. In February, Oz sent a letter to Maine Governor Janet Mills, a Democrat, raising concerns about the state’s Medicaid-funded treatment program for children with autism. The letter demanded detailed information on how Maine is identifying and preventing fraud, as well as recovering funds that have been improperly spent. Mills described the initiative as a “political attack,” highlighting the tension between the administration’s actions and its critics.
Broader Anti-Fraud Measures
The CMS director has extended similar restrictions to companies offering durable medical equipment, such as wheelchairs and hospital beds. This nationwide six-month pause targets industries deemed prone to fraudulent practices. Oz has concentrated his efforts in the Los Angeles area, suspending $70 million in payments to 773 hospices and 23 home health agencies flagged for misconduct. Additionally, hundreds of these providers have had their credentials revoked or deactivated.
Enhanced scrutiny has also been applied to new hospice providers in Arizona, California, Georgia, Ohio, Nevada, and Texas. Meanwhile, home health agency claims in Florida, Illinois, Oklahoma, and North Carolina are undergoing expanded reviews. These actions reflect a multifaceted strategy to root out fraudulent behavior across various states and sectors.
Impact on Legitimate Providers
Despite these efforts, the new moratorium could pose challenges for authentic service providers. The National Alliance for Care at Home warned that such a pause might exacerbate access-to-care issues, particularly in regions experiencing rising demand or limited resources. “Enrollment restrictions raise significant concerns about patient access, leading to longer wait times, fewer service options, and a decline in care quality,” the alliance stated.
An enrollment moratorium raises serious access-to-care concerns in areas where patient demand is growing or existing capacity is already strained, leading to longer wait times, reduced service availability, and fewer choices for patients – particularly in rural or underserved communities.
The administration has also taken action in Minnesota, halting Medicaid payments earlier this year. Oz has been proactive in communicating with state officials, filming videos and sending letters to governors to encourage the development of fraud prevention plans. His requests include revalidating providers and strengthening the integrity of state programs.
These strategies, while aimed at curbing misconduct, have sparked debate over their potential effects on legitimate providers. The National Alliance noted that it and other organizations have shared recommendations with CMS to target fraudulent actors without unfairly burdening those operating in good faith. The challenge lies in balancing strict oversight with the need to ensure uninterrupted care for patients.
As the administration continues to push its anti-fraud agenda, the focus remains on preventing financial exploitation. However, critics argue that the measures could inadvertently affect the availability of services for those in need. With ongoing efforts in multiple states, the impact of these policies on healthcare access and quality will likely become a key point of discussion as the midterms approach.
