CMS Enrollment Moratoria: Change of Ownership Implications for Home Health and Hospice Transactions

AGG CHOW attorneys Hedy Rubinger, Jessica Grozine, and Maggie Callahan co-authored an article for the American Health Law Association examining how the Centers for Medicare & Medicaid Services’ (“CMS”) nationwide enrollment moratoria affect transactions involving home health agencies (“HHAs”) and hospices.

On May 13, 2026, CMS imposed six-month nationwide moratoria on new Medicare enrollments for HHAs and hospices, including new branches and practice locations, as part of a broader program integrity strategy. “Although the moratoria do not terminate existing enrollments or prohibit all transactional activity, they substantially alter the risk calculus for buyers, sellers, and investors,” Hedy, Jessica, and Maggie stated.

The article analyzes how the moratoria interact with Medicare’s “36-month rule,” which governs certain changes in majority ownership. “The interaction between the moratoria and the 36-month rule converts an otherwise straightforward change of ownership (“CHOW”) into a transaction that cannot be completed on the original timeline, or at all, if the transaction would require a new enrollment during the moratorium period.”

Hedy, Jessica, and Maggie also outlined a three-part framework for assessing exposure before signing, including covering regulatory feasibility, compliance risk and business plan risk. “Parties should not assume the moratoria will cease at the end of the current six-month period,” they advised. “Early regulatory diligence, careful 36-month rule analysis, and thoughtful risk allocation will be essential for practitioners guiding clients through this landscape.”

To read the full article, please click here.