Medicaid Program Integrity

Medicaid Program Integrity: Tracking Federal and State Action

This page tracks program integrity actions being taken by CMS, Congress, and state Medicaid agencies — it is not a statement of AAHomecare's own position. For the Association's stance on fraud and abuse oversight, see AAHomecare's Anti-Fraud Statement.

Medicaid program integrity, the effort to root out fraud, waste, and abuse in state Medicaid programs, has become an active area of federal and state action in 2026. CMS, Congress, and individual states are moving on multiple fronts at once: funding actions, information requests, provider enrollment moratoria, and revalidation mandates. This page summarizes what outside agencies are doing so members can track developments that may affect their state's Medicaid DME/HME programs.

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Federal Action

  1. Nationwide DMEPOS enrollment moratorium (effective Feb. 27, 2026): CMS imposed a six-month, nationwide moratorium on new Medicare enrollment for seven categories of DMEPOS "medical supply company" suppliers, citing longstanding program integrity concerns. Existing enrolled suppliers are not affected. (Federal Register notice)
  2. State discretion on Medicaid: CMS has left it to each state to decide whether to impose a parallel moratorium on new DME enrollment in its own Medicaid/CHIP program. This means the DME enrollment landscape may now differ significantly by state, members should confirm requirements with each state Medicaid agency in which they operate.
  3. Nationwide home health/hospice enrollment moratorium (effective May 13, 2026): A separate six-month, nationwide moratorium halted new Medicare enrollment of home health agencies and hospices.
  4. CRUSH RFI: CMS's Request for Information on Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) is seeking public input on broader anti-fraud regulatory approaches. AAHomecare submitted comments on this RFI, see the Association's response.
  5. State-specific federal financial actions: CMS has taken funding-related actions (deferrals of federal Medicaid funds, formal information requests) directed at individual states, including Minnesota and California, as well as inquiry letters sent to several other states.

State-Level Medicaid Action

  1. Florida: The Agency for Health Care Administration (AHCA) imposed a statewide Medicaid moratorium on new DME (Provider Type 90) enrollment, effective March 20, 2026, the first state to pair a Medicaid-specific DME moratorium with the federal action above.
  2. Missouri: The Missouri Department of Social Services implemented a statewide six month enrollment moratorium for new DMEPOS and Consumer Directed Services/Personal Care providers, effective August 1, 2026. The moratorium does not impact actively enrolled providers, applications received prior to August 1, or providers revalidating an active enrollment.
  3. New York: On July 30, 2026, the state Medicaid program announced a six-month moratorium on new Medicaid provider enrollments and change-of-ownership applications, in response to a CMS directive requiring expedited revalidation of enrolled providers.
  4. Nevada: Nevada Medicaid implemented a state DMEPOS enrollment moratorium corresponding to the federal action, effective February 27, 2026. New DMEPOS enrollment applications received on or after that date are denied for the duration of the moratorium; revalidations, most changes of ownership, and updates to existing enrollments are not affected. (Nevada Medicaid Web Announcement 3907)
  5. Ohio: The Ohio Department of Medicaid (ODM) implemented an enrollment moratorium in effect May 14–November 14, 2026, in accordance with CMS-6101-N and 42 CFR 455.470. This moratorium applies to Home Health, Hospice, and related provider types (including waiver individuals/organizations, private duty nurses, personal care aides, and home care attendants). ODM separately implemented a DMEPOS-specific enrollment moratorium running June 10–December 10, 2026, aligned to CMS-6099-N.
  6. Rhode Island: The Executive Office of Health and Human Services announced a DMEPOS provider enrollment moratorium effective April 1, 2026, for six months. This moratorium does not impact existing providers or newly enrolling providers that had already submitted an application prior to April 1, 2026.

AAHomecare continues to monitor reports of similar action in other states.

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