Crushing Fraud, Waste, & Abuse
CMS is crushing fraud, waste, and abuse to protect Americans.
Alert: CMS Implements Temporary Nationwide Enrollment Moratorium on Home Health Agencies and Hospices
On May 13, 2026, CMS implemented a six-month nationwide moratorium on Home Health Agencies (HHAs) and Hospices. Any initial or change in majority ownership (CIMO) applications submitted by HHAs and Hospices after the implementation of the moratorium will be denied.
For more information, refer to the Federal Register Notice here or Provider Enrollment Moratoria.
CMS Reports Highest Program Integrity ROI Ever Recorded
Due to the bold actions this administration has taken to crush fraud, CMS delivered unprecedented results in Fiscal Year (FY) 2025, protecting taxpayer dollars and holding bad actors accountable like never before.
Total Medicare program integrity savings surged 59%, from $26.3 billion in FY 2024 to a record-shattering $41.9 billion in FY 2025. The FY 2025 Medicare Return on Investment (ROI) reached $22.3 to 1, up from $14.6 to 1, the highest ROI ever.
More information can be found here.
Program Integrity Demonstrations and Initiatives Map
Fast Facts
Learn more about program integrity risks to CMS programs and the steps CMS is taking to crush fraud.
The FDOC
Hospice Fraud
FY 2025 ROI
Dual Enrollment
Fraud Spotlights
See below for details on the biggest risks to CMS programs.
DME Fraud
Some DMEPOS suppliers billed Medicare for items that were never provided or submitted bills without the beneficiary’s knowledge or consent. Some providers also accepted kickbacks to bill DMEPOS when the item was not medically necessary.
Inappropriate DMEPOS billing could affect available benefits, increase out-of-pocket costs, or indicate stolen health information.
ACA Marketplace Fraud
Fraudsters continue to target the ACA Marketplace by submitting fraudulent applications, collecting millions of dollars in improper commissions.
CMS is cracking down by strengthening its ability to resolve consumer complaints, cancel unauthorized enrollments, and recoup payments inappropriately paid to the issuer on the consumer's behalf.
Enrollment Moratoria
CMS is continuing its broader crackdown on fraud by imposing nationwide Medicare enrollment moratoria focused on high-risk providers, including home health agencies, hospices, and certain Durable Medical Equipment, Prosthetics, Orthotics, and Suppliers (DMEPOS) suppliers.
The moratoria prohibit new enrollments for those provider types for a six-month window.
Page Last Modified:
06/08/2026 02:07 PM