Trump administration freezes Medicare enrollments for home health and hospice
The Trump administration's Department of Health and Human Services placed a six-month moratorium on new Medicare enrollments from home health care and hospice providers effective immediately Wednesday, citing fraud concerns.
Objective Facts
The Trump administration's Department of Health and Human Services placed a six-month moratorium on new Medicare enrollments from home health care and hospice providers, effective immediately Wednesday, as part of efforts to combat fraud. The decision prevents these providers from signing up to receive reimbursements from Medicare. CMS Administrator Mehmet Oz announced the pause in partnership with Vice President Vance's Anti-Fraud Task Force, stating the administration has seen "systemic and deeply troubling fraud in the hospice and home health space." Vance simultaneously announced that the administration is deferring $1.3 billion in Medicaid payments to California, following a previous deferral of more than $350 million to Minnesota. CMS said those already enrolled in Medicare will not be impacted by this decision.
Left-Leaning Perspective
The National Alliance for Care at Home, the largest organization advocating for home healthcare providers, warned in a statement that the moratorium "could hurt legitimate providers of hospice services and limit patients' access to care," raising "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 Alliance said it supports efforts to root out fraud but prefers targeted strategies to a sweeping moratorium, which it said raises concerns about access to care, reduces competition, and slows innovation. Andy Schneider, a research professor at Georgetown University specializing in Medicaid fraud, questioned the effectiveness of withholding $1.3 billion from California, stating "It's not at all clear how deferring $1.3 billion will actually reduce fraud against California's Medicaid program or help the millions of Californians who rely on Medicaid for access to care and protection against medical debt." Attorney Michelle Huntsman from Holland & Knight, who specializes in healthcare law, warned that while patients' access is unlikely to be affected in the short term, the freeze means increasing scrutiny for providers, and stated "We don't know when this moratorium will end" and "This is probably just the first lever that medicare is going to pull." The National Alliance for Care at Home noted that public reports show fraud is concentrated in specific geographies and among specific actors, signaling that targeted reforms are needed rather than broad moratoria, and stated they have repeatedly provided CMS with recommendations to fight fraud without creating unnecessary burden for good-faith providers. Left-leaning coverage has criticized the administration for focusing its anti-fraud efforts primarily on Democratic-led states. In April, CMS acknowledged to The Associated Press that it made a significant error in figures it used to help justify a fraud probe in New York, with the Washington Times noting this acknowledgment "deepened doubts in the administration's methods and raised a common criticism that has been made about the second Trump administration - that it tends to attack first and confirm the facts later."
Right-Leaning Perspective
Townhall, a conservative outlet, reported that the action "continues the Trump Administration's crackdown on fraud, waste, and abuse in the Medicare program" and highlighted that "CMS Administrator Mehmet Oz says they've found that at least half of the hospices in LA alone are fraudulent and that they've now suspended 800 of them. These fraudulent hospices cost taxpayers over a billion dollars last year." The Daily Caller stated that "Vance's Anti-Fraud Task Force just withheld $1.4 BILLION in federal funding" and characterized the move as part of broader efforts "to eliminate healthcare fraud across the U.S." HotAir reported Vice President Vance saying "I'm sure there are going to be some politicians who say what we're doing here is harming the Medicaid program. We're trying to save the Medicaid program from dysfunctional state bureaucrats" and warning that allowing money to go to fraudsters "will eventually destroy the Medicaid program." Conservative media emphasized that "approximately 90% of the suspended providers never even contacted CMS after their payments were cut off," interpreting this silence as a "powerful signal that many of the suspended providers were not legitimate operations," noting that "That is not the behavior of legitimate businesses that depend on Medicare reimbursements to care for patients." The National Partnership for Healthcare and Hospice Innovation (NPHI), which first called for a nationwide moratorium, said "we are fully supportive of CMS taking this decisive step to protect patients, families, and the integrity of the Medicare hospice benefit," and stated "For too long, fraudulent actors have exploited regulatory gaps to infiltrate hospice care, undermine public trust, and take advantage of vulnerable Americans." RedState reported that Dr. Mehmet Oz blasted California and alleged international involvement in the fraud, claiming "We've got Russian government involvement, we believe, in Los Angeles. We've got the Chinese government involved in a big fraud ring in New York," and mentioned a Cuban connection. Right-leaning outlets did note that CMS Administrator Mehmet Oz did not provide specific evidence to reporters to explain why the Trump administration believes a nationwide freeze is necessary as opposed to targeted action in specific areas.
Deep Dive
Hospice is a growing sector—the number of hospice providers grew an average of 7.8% per year nationally between 2019 and 2023 according to the nonpartisan Medicare Payment Advisory Commission. More than 1.8 million Medicare beneficiaries received hospice services in 2024, with expenditures reaching $28.3 billion. A CBS News investigation based on state and federal data raised concerns about potentially fraudulent hospice companies and charges, particularly in California, where over 700 of roughly 1,800 hospices in LA County trigger multiple red flags for fraud as defined by the state. The Trump administration's approach reflects genuine fraud concerns backed by documented prosecutions and state acknowledgment of problems. Federal officials have pointed to recent prosecutions including a Massachusetts operator sentenced to 12 years and ordered to pay nearly $100 million, and a decade-long kickback network in Illinois and Indiana, as well as operators in Ohio and Texas caught billing for care to dead patients. However, the administration's execution has faced credibility issues. In at least one case, the administration has erred in its accusations—CMS acknowledged to The Associated Press in April that it made a significant error in figures it used to help justify a fraud probe in New York. The key tension is whether targeted, data-driven approaches can address the concentrated geographic fraud while preserving access and competition, or whether a nationwide approach is necessary to prevent bad actors from evading detection by shifting across state lines. The six-month freeze will likely be extended if substantial work remains, and the real test will be whether intensive investigations during the moratorium period lead to systemic reforms that actually prevent re-entry of fraudulent operators without meaningfully restricting legitimate providers.