In brief: New moratorium, new Medtrade owner, new stay-of-enrollment scope

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) will implement a six-month, nationwide data-driven moratorium on new Medicare enrollment for hospices and home health agencies (HHAs).

CMS says the moratorium, which will temporarily halt the influx of new providers into these high-risk categories, continues the Trump Administration’s crackdown on fraud, waste and abuse in the Medicare program.

“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,” said CMS Administrator Dr. Mehmet Oz. “Today we’re shutting the door on fraud – preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them.”

In February, CMS announced a six-month moratorium on DMEPOS suppliers.

During the moratorium, CMS says it will intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud.

Recent CMS action, undertaken in coordination with Vice President JD Vance’s Anti-Fraud Task Force, has included the suspension of payments to 773 hospices and 23 HHAs suspected of fraud in Los Angeles alone, representing $70 million in suspended funds thus far.

Additional CMS work has included:

Revoking or deactivating hundreds of hospices and HHAs engaged in improper or fraudulent activity;

• Conducting nationwide hospice site visits to verify operations and identify suspicious activity;
• Heightened oversight of newly enrolled Medicare hospice providers in states with elevated fraud risk, including Arizona, California, Georgia, Ohio, Nevada and Texas;
• Launching a new, publicly available hospice scoring system to increase transparency and identify providers with troubling patterns of utilization, quality, or compliance;
• Implementing enhanced enrollment screening measures for high-risk HHAs, including site verification of reported practice locations and fingerprinting-based background checks; and
• Expanding a demonstration project that allows pre- and post-claim review of HHA claims in Florida, Illinois, Oklahoma, Ohio, North Carolina, and Texas to stop improper payments before they occur.

Additional information on the moratorium can be found via the Federal Register at:

• https://www.federalregister.gov/d/2026-09717 (Home Health)
• https://www.federalregister.gov/d/2026-09718 (Hospice)

Emerald Holding and its Medtrade trade show will have new owner

NEW YORK – Apollo-managed funds have entered into separate definitive agreements to acquire Emerald Holding, Inc., which organizes Medtrade, and Questex, with the intention to combine the businesses to create a leading North American B2B experiential events and media platform, in an all-cash transaction.

Apollo says Emerald and Questex, together, would create a scaled B2B events platform with approximately 160 events across complementary end markets, combining Emerald’s category-leading exhibitions with Questex’s differentiated events portfolio and 365-day digital engagement model. It says the combined business is expected to be well-positioned to drive organic growth and serve as a strategic partner of choice for founders and operators in the large and fragmented B2B events landscape.

“Over the past several years, we have transformed the portfolio with a clear focus on higher-growth, market-leading brands, building a more diversified mix of events and the strongest portfolio in our history,” said Hervé Sedky, president and CEO of Emerald. “We are grateful to Onex for their partnership and support in building Emerald into what it is today. We believe the acquisition by Apollo Funds and the subsequent combination with Questex will provide the enhanced resources, strategic support, and long-term capital to accelerate our growth and deliver lasting value for our customers, employees, and stakeholders.”

The transaction is expected to be completed in the second half of 2026, subject to customary closing conditions and regulatory approvals.

Questex has a presence in the life sciences, health and wellness markets, as well as living, and entertainment and infrastructure. In the health market, it owns Fierce Healthcare and the Fierce Health Payer Summit.

Apollo recently bought a stake in McKesson’s Medical-Surgical Solutions segment.

Stakeholders press CMS for clarification on vent requirement

WASHINGTON – AAHomecare has joined several advocacy and patient groups in signing a letter to CMS Administrator Mehmet Oz requesting immediate clarification on guidance for continuing-use criteria for home mechanical ventilators (HMVs) and respiratory assist devices (RADs) for Medicare beneficiaries with chronic respiratory failure due to COPD. In the absence of clear guidance, informal supplier surveys show that more than 50% of beneficiaries using HMVs or RADs could be required to return their equipment and discontinue therapy, even when their physicians believe it is medically necessary. Stakeholders argue that strict adherence to Medicare’s adherence requirement of four or more hours of use per day on 70% of days within a 30-day period does not reflect the clinical course of COPD. They emphasize that patients often experience variable tolerance during the first six months of therapy and that a single month of sub‑threshold use during the maintenance phase should not trigger loss of coverage. Stakeholders also request clarification on the threshold requirement for high‑intensity settings for RAD bi‑level pressure capability devices with a back‑up rate. They urge CMS to issue guidance applicable to all audit contractors before the end of April, retroactive to April 1, to ensure that patients who medically require these devices can maintain access.

• Related: Viemed is hitting an inflection point in its ventilator business under new Medicare rules, with stronger compliance and accelerating referrals offset by higher patient turnover.

CMS expands scope of stay-of-enrollment

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) on May 18 will begin applying additional scenarios where stay-of-enrollment can be applied on non-compliant DMEPOS suppliers, AAHomecare reports. Those scenarios:

• Liability insurance and surety bond cancellations
• Site visit non-compliance determinations
• Failure to respond to development requests within 30 days for revalidations or changes to information

Background

Stay-of-enrollment is a preliminary action CMS can take on non-compliant providers. Instead of revoking or deactivating supplier numbers, for certain scenarios, suppliers can be put on a stay-of-enrollment that will pause their enrollment providing up to 60 days to correct the non-compliance. The stay was first implemented for DMEPOS providers in 2024 for specific scenarios such as failure to respond to revalidation request or timely reporting of address changes.

For more information

Check out this updated MLN Matters article.

SOAR Act surpasses 50 sign-ons

WASHINGTON – More than 13 leading respiratory patient, physician and provider organizations applaud the now more than 50 co-sponsors for the Supplemental Oxygen Access Reform (SOAR) Act (H.R. 2902/S.1406), according to the Council for Quality Respiratory Care (CQRC).  The SOAR Act would modernize Medicare’s oxygen benefit, improve access to respiratory therapists, and strengthen patient protections – helping reduce avoidable hospitalizations and allowing people to remain active and independent, supporters say. Importantly, the SOAR Act would also restore access to liquid oxygen, which has become nearly impossible to obtain in many parts of the country, despite being essential for patients with the highest needs, they say. “By passing the SOAR Act, Congress can help the more than 1.5 million individuals living with COPD, heart disease, pulmonary hypertension, pulmonary fibrosis, people awaiting lung transplants and other advanced chronic respiratory diseases who rely on supplemental oxygen live independently and healthily,” the organizations stated in a letter to Congress. This bill also addresses challenges faced by people who are low-income and rural and medically underserved who currently struggle to secure adequate care.”

• Related: CQRC sees momentum on SOAR Act as engagement deepens.

North Carolina extends Medicaid rate floor

RALEIGH, N.C. – Both chambers of the North Carolina General Assembly have approved a one‑year extension of the state’s Medicaid rate floor, moving its expiration from June 30, 2026, to June 30, 2027, according to a bulletin from AAHomecare. House Bill 696 was signed into law by Gov. Josh Stein on April 30. This extension builds on a success for North Carolina providers first achieved in 2021, when the state enacted Senate Bill 594 to establish a Medicaid rate floor for DMEPOS. That legislation set reimbursement at 100% of the lesser of a supplier’s usual charge or the maximum allowable Medicaid fee‑for‑service rate. The five‑year protection, effective July 1, 2021, ensured that Medicaid managed care organizations could not cut DMEPOS reimbursement below sustainable levels. The AAHomecare team worked closely with Dick Carlton, ACMESA’s lobbyist, and Hampton Billups with Checkmate, who was retained by Aeroflow Health.

• Related: Provider Tyler Riddle lobbies for payment parity for Georgia Medicaid.
• Related: Stakeholders get parity bill passed in NY.

AMA announces educational video series on caring for people with disabilities

CHICAGO – The American Medical Association (AMA) has announced a collaboration with the University of Colorado Anschutz on a new educational video series to help physicians and medical students provide high-quality, patient-centered care for people with disabilities. The Caring for People with Disabilities Series is free and available on AMA Ed Hub, AMA’s online learning platform. “The AMA and physicians everywhere want all patients to receive the best possible care – and that includes patients with disabilities,” said AMA President Bobby Mukkamala, MD. “This new video series addresses that challenge directly, and gives physicians and medical students practical tools to better understand their patients’ needs and improve access to care.” The video series offers free opportunities to earn continuing medical education (CME) credit. Each module in the series is under 30 minutes and accompanied by searchable transcripts. The first five modules in the series are available now and include: Foundational Concepts, Foundations of Clinical Care, Medical Decision-Making, Accommodations and Accessibility in Healthcare and Effective Communication.