New York and Indiana have both enacted six-month Medicaid enrollment moratoriums on home care providers in 2026, freezing new provider applications, ownership changes, and expansions. The moves follow similar federal action by CMS and mirror moratoriums already in place in Arkansas, Nevada, Ohio, and California. For existing home care agencies, the moratoriums mean less new competition but also more regulatory scrutiny, slower transactions, and continued reimbursement delays — making steady cash flow more important than ever.

Two more states just hit pause on new Medicaid home care enrollment — and the ripple effects are already reaching agency owners.

In late July 2026, New York and Indiana both announced six-month moratoriums freezing new Medicaid provider enrollment for home care services — part of a growing national trend. Neither state is acting in isolation: New York and Indiana now join Arkansas, Nevada, Ohio, and California, which have all imposed similar restrictions, following the federal Centers for Medicare & Medicaid Services’ (CMS) nationwide moratorium on new Medicare home health and hospice enrollments earlier this year.

For home care agencies, these moratoriums are more than a regulatory footnote — they’re reshaping how the industry operates, competes, and manages cash flow.

What’s Happening in New York

New York State Medicaid Director Amir Bassiri announced on July 30, 2026, a six-month moratorium on new Medicaid provider enrollments across six “high-risk” categories, including licensed home care service agencies (LHCSAs), along with laboratories, DME suppliers, pharmacies, applied behavioral analysts, and managed long-term care plans, according to Holland & Knight’s analysis of the announcement. The stated goal is to give the state time to complete a revalidation process for currently enrolled providers.

It’s worth noting that New York has a track record of extending “temporary” pauses — a prior LHCSA moratorium that began in 2018 wasn’t formally lifted until 2020, and didn’t fully resolve in practice until 2022. Agencies operating in New York should plan for the possibility that six months could stretch longer.

The moratorium’s impact on mergers, acquisitions, and ownership changes is still unclear. Stock deals involving an already-enrolled provider likely won’t trigger the freeze, but asset purchases by buyers without an existing Medicaid enrollment may be directly affected — a detail that matters for agencies weighing growth through acquisition right now.

What’s Happening in Indiana

Indiana’s moratorium, effective August 1, 2026, follows a state audit that uncovered roughly $200 million in improper Medicaid payments among the state’s largest attendant care providers — including missing background checks, incomplete service plans, and gaps in visit documentation. The pause blocks new provider enrollment, ownership changes, county expansions, and service expansions for agencies under several Home and Community-Based Services (HCBS) waivers, including PathWays for Aging and Community Integration and Habilitation, per McKnight’s Home Care’s coverage of the announcement.

Indiana becomes the fifth state to enact this kind of moratorium tied to the federal crackdown on fraud, waste, and abuse in home-based care.

What This Means for Home Care Agencies

Whether you operate in New York, Indiana, or are watching from another state, these moratoriums point to a broader trend agencies should prepare for:

• Slower growth through new enrollment. New agencies can’t get licensed, and existing agencies may face limits on expanding into new counties or service lines.
• Increased scrutiny on existing providers. Revalidation reviews and audits mean more documentation demands and potential delays or holds on claims while compliance is verified.
• Complicated M&A timelines. Agencies considering a sale, acquisition, or ownership change need to build moratorium-related delays into their planning.
• Reimbursement timelines that are already slow tend to get slower during periods of heightened state scrutiny, as agencies navigate revalidation paperwork and payers double-check claims.

In short: for agencies that are already enrolled and in good standing, a moratorium can actually reduce competitive pressure from new market entrants. But it also raises the cost of doing business — more paperwork, more waiting, and less room for cash flow error.

How PRN Funding Helps Agencies Stay Steady

Regulatory uncertainty doesn’t have to mean cash flow uncertainty. PRN Funding works exclusively with healthcare businesses — including private duty home care agencies and home health care agencies paid through Medicaid waivers and state government programs — to turn outstanding invoices into working capital, often within 24–48 hours.

When Medicaid reimbursement timelines slow down due to revalidation reviews, audits, or moratorium-related administrative backlogs, factoring gives agencies a way to keep payroll, staffing, and operations running without waiting 45–65 days (or longer) for a claim to clear. Approval is based on the creditworthiness of your payer — Medicaid, state agencies, or the VA — not your agency’s credit history, which makes it a practical option even for newer or growing agencies navigating a tighter regulatory environment.

As more states follow New York’s and Indiana’s lead, agencies that build predictable cash flow into their operations now will be better positioned to weather the next enrollment freeze, audit cycle, or reimbursement delay — whenever and wherever it happens.

Ready to protect your agency’s cash flow against Medicaid delays? Contact PRN Funding to learn how home care factoring can keep your operations steady, no matter what changes with state Medicaid enrollment.