Literature Review

California targeted in House Committee investigation of hospice fraud

3 potential policy options for high-acuity palliative services Hospice News; by Jim Parker; 3/24/26 The Medicare Payment Advisory Commission (MedPAC) is considering new policy options to expand access to high-acuity palliative services for hospice patients. The treatments under exploration include palliative radiation, chemotherapy, dialysis and blood transfusions. Though these treatments can aid in palliation, patients often do not receive them due to high costs and questions as to whether they fall within the scope of the Medicare Hospice Benefit. To identify potential approaches, MedPAC conducted a literature review, stakeholder interviews, site visits and data analyses. 

50 years ago, Karen Quinlan’s coma sparked the movement for patients’ rights near the end of life The Conversation; by Kalpana Jain; 3/23/26 March 31, 2026, marks 50 years since a landmark decision that shapes American patients’ rights every day: the New Jersey Supreme Court ruling in the case of Karen Ann Quinlan, who had suffered an irreversible coma. Quinlan’s case established for the first time that decisions near the end of life should be made by patients and families, not by doctors and hospitals alone. As a bioethicist, I have taught and written extensively about the profound impact the Quinlan case has had on law, bioethics and the pursuit of death with dignity. A decade after the Quinlan case, New Jersey created a Bioethics Commission to study advancing health care technology in light of the decision’s principles. The commission’s proposed legislation establishing advance directives was enacted on July 11, 1991. I was privileged to lead this project, as staff to the commission. Today, all 50 states have advance directive laws that allow competent adults to plan ahead and put their wishes for end-of-life care in writing.

Scotland rejects assisted dying at final stage: MSPs cite coercion fears and palliative care gaps in decision Newser; by Arden Dier; 3/18/26 Scotland has just turned down a chance to become the first part of the UK to allow assisted dying despite widespread support among the public. After five debate sessions and a rare Friday sitting, members of the Scottish Parliament rejected the Assisted Dying for Terminally Ill Adults (Scotland) Bill late Tuesday by 69 votes to 57, ... The free vote cut across party lines, ... Opponents repeatedly warned of coercion ... and arguing efforts should instead focus on better end-of-life care. Supporters ... shared personal stories of family members' suffering, insisted robust protections—including doctor checks to determine whether a person was being coerced—were built in.Editor's Note: Scotland's debate resonates with those throughout the U.S. and other countries. I invite you to revisit a "most read" article from our newsletters, "PositivelyJAX Award: The purple bench of Compassionate St. Augustine." Pair these with Daniel Goleman's "cognitive empathy," for which you might not agree--or feel it the same as another--but you do seek to learn and understand the other person's perspective.

Hospice CARE Act reintroduced Hospice News; Jim Parker; 3/18/26 Rep. Linda T. Sánchez (D-Calif.) and Sen. Mark Warner (D-Va.) have re-introduced the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, designed to modernize the Medicare Hospice Benefit, fight fraud and expand access to care. The bill contains a blend of program integrity provisions and payment reforms intended to “strengthen” the benefit, according to the lawmakers. The bill would establish new safeguards to prevent fraudulent providers from enrolling in Medicare and bolster federal oversight of hospices. It would also change payment structures to incentivize high-quality care. 

More states push to let terminally ill patients use cannabis in hospitals GreenState; by Taylor Engle; 3/4/26 ... Across multiple state legislatures, lawmakers are now advancing bills to let seriously ill patients use medical cannabis inside hospitals, hospice centers, and other care facilities. In the current session, proposals in Connecticut, Hawaii, Oregon, Virginia, and Washington State have moved forward, even as one similar bill stalled in Mississippi this week. At the heart of this push is a moral question that many find hard to dismiss: if a qualifying patient is legally using cannabis to manage pain, nausea, anxiety, or other symptoms at home, why should that care stop the moment they enter a hospital or hospice? Advocates have framed it less as a legal loophole and more as a gap in dignity and continuity of care: one that these bills aim to close.

Oregon legislature passes bill Stop Bad Actors from Taking Advantage of Hospice Patients OregonLegislature.gov, Salem, OR; Press Release, Office of Senator Deb Patterson; 3/4/26 Hospice began as a movement to provide end-of-life care for terminally ill patients. However, corporate investors have started buying up hospice agencies and reducing services as they try to maximize profits. In some states, this has led to patterns of fraud, abuse, and neglect. Today, the Oregon Legislature passed the Protecting the Dying Act (SB 1575), which enhances state oversight of hospice agencies. ... Senator Patterson began work on this issue after it was brought to her by a local hospice provider in her community. Iria Nishimura, CEO of Willamette Vital Health in Salem, said, “Hospice serves patients and families during the most vulnerable time of life. The state has a responsibility to ensure that providers entering this field are qualified, ethical, and capable of deliver high-quality care.”

As more states legalize assisted suicide, boomers contemplate end-of-life choices The Washington Post; 2/24/26 While polling has shown that a majority of Americans favor the legality of the practice for terminally ill patients, people are more split on the morality. [Access may be limited per paywall.]

Oregon considers bill to stop hospice scammers from entering state Hospice News; by Jim Parker; 2/13/26 State lawmakers in Oregon are mulling a bill designed to combat hospice fraud. Senate Bill 1575 would prevent hospices that have committed fraud or provided substandard care in other states from setting up shop in Oregon. If enacted, the Oregon Health Authority, a state agency, would examine the history of companies seeking to open hospices before approving a license, including Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results, among other information. 

New Jersey's new Community-Based Palliative Care Medicaid (CBPC)  State of New Jersey - Department of Human Services - Division of Medical Assistance & Health Services; email and website notifications; 2/9/26 Community-Based Palliative Care is a benefit available to NJ Family Care members, starting April 1, 2026. The benefit was signed into the law by Governor Murphy on December 21, 2023, underscoring the state's commitment to supporting residents facing serious illness. Community-Based Palliative Care (CBPC) is designed to support people living with serious health conditions by helping manage symptoms, coordinating care, and making the healthcare system easier to navigate. You can receive CBPC while continuing your current treatments. CBPC is not hospice; a terminal diagnosis is not required. It is designed to give you extra support alongside the care you already receive.

What hospice leaders need to know about H.R.7148 - 119th Congress (2025-2026): Consolidated Appropriations Act, 2026 | Congress.gov | Library of Congress | signed by the President, 2/3/26Congress.gov; content below gleaned by Judi Lund Person, Guest Editor

What Salem-area lawmakers are prioritizing for the 2026 session Salem Reporter, Salem, OR; by Rachel Alexander and Hailey Cook; 2/4/26 ... Oregon’s month-long legislative session got underway on Monday, Feb.2. The fast-paced short session occurs in even years. ... Hospice care oversight: SB 1575 would add protections for patients in hospice care. The new rules would include requiring a background check for business owners, ensuring agencies have the financial resources to care for patients and pausing the issuance of new hospice licenses until the state rules are implemented.  Patterson said the change was at the request of the Oregon Hospice and Palliative Care Association. “In other states there has been a lot of fraud and abuse, and we want to prevent that from happening here in Oregon,” she said. 

Congressional hearing confronts hospice, health care fraud Hospice News; by Jim Parker; 2/4/26 Regulatory reform, better data and more state-federal and other stakeholder partnerships are necessary to combat health care fraud in the United States, including among hospices. This was a key message in a recent hearing by the House Energy and Commerce Subcommittee on Oversight and Investigations. Hospice fraud has been rampant in certain states. Unscrupulous providers have enrolled patients in hospice who were not eligible or without their knowledge or consent. They have also transferred patients from one hospice to another in exchange for monetary payments, engaged in “license flipping,” and paid illegal kickbacks for referrals, among other abuses.