Literature Review

West Coast fraud and AI: DOJ expands healthcare fraud enforcement into technology-driven markets JDSupra | Proskauer Health Care Law Brief; by Devin Cohen, Lara Feder, Matthew Westbrook; 6/3/26 On April 30, 2026, the Department of Justice (“DOJ”) announced the creation of the West Coast Health Care Fraud Strike Force, a coordinated enforcement initiative focused on healthcare fraud in Arizona, Nevada, and Northern California. ... DOJ’s announcement also reflects the government’s growing focus on technology-enabled healthcare fraud risks. ... In its announcement, DOJ specifically highlights recent prosecutions involving digital health executives and healthcare technology-related fraud schemes in Northern California and Arizona.

A month’s worth of fraud busting in 10 notable quotesHealthExec; by Dave Pearson; 5/26/26This month, HHS’s Senior Medicare Patrol program designated the first workweek of June Medicare Fraud Prevention Week... Ahead of June 1 to 5, here’s a timeline of fraud-related news, views and developments as captured in concise statements uttered or written in May. [See article for all 10 quotes.]

CMS myth vs. fact: what hospice and home health providers need to know about the new Medicare enrollment moratoria JD Supra; by Stephen Angelette, Mary Canavan, Simran Nijjar, Ross Sallade, Elizabeth Tucker, and Deja Williams; 5/26/26 [Responding to the CMS nationwide six-month moratoria barring new Medicare enrollments for hospice and home health agencies (HHAs), effective May 13 ... ] Any actions that trigger an initial Medicare enrollment are prohibited during the moratoria. This can include changes in ownership, new practice locations, additions of provider types, or other transactions requiring a new enrollment application.In this alert, we address common myths surrounding the moratoria and key considerations for providers during the six-month period. Guest Editor's Note, Judi Lund Person: Review this guidance for application to your hospice or home health planning, including mergers, acquisitions, and establishment of new practice locations or new branches.   

CMS enrollment moratoria: CHOW implications for home health and hospice transactions JD Supra; by Arnall Golden Gregory LLP; 5/22/26 ... Although the announcement has significant implications for new HHA and hospice entrants, the practical impact on change of ownership (“CHOW”) transactions is narrower: the moratoria should affect only those CHOWs that are treated as new initial enrollment under the Medicare “36-month rule.” ...Key Takeaways

GAO makes MedPAC appointments U.S. Government Accountability Office (GAO), Washington, DC; Press Release; 5/22/26 Orice W. Brown, Acting Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), today announced the appointment of the Chair, Vice Chair, and two new members to the Medicare Payment Advisory Commission (MedPAC). She also reappointed two current members. MedPAC advises Congress on payments to providers in Medicare’s traditional fee-for-service program and to health plans participating in the Medicare Advantage program. ... 

Development of the revised CAHPS Hospice Survey Journal of Pain and Symptom Management; by Danielle Schlang, MA, Melissa A. Bradley, BA, and Rebecca Anhang Price, PhD; 5/18/26 ... Methods: We conducted a plain language review and environmental scan, refined existing survey instrument wording, drafted candidate survey items addressing new topics of interest, and conducted 7 rounds of cognitive interviews with a total of 59 family caregivers of hospice decedents. Results: Cognitive interview respondents consistently interpreted “respecting [the patient’s] wishes,” and “listening to the things that matter most” and found these concepts relevant to their family members’ hospice care experiences; in contrast, they found the phrases “cultural practices” and “choosing what to do next” confusing or unclear. ... Conclusion:  The revised CAHPS Hospice Survey simultaneously adds new topics prioritized by stakeholders and reduces survey complexity and length. Editor's Note: This journal article includes a downloadable "Journal Pre-proof" PDF. Its Appendix B (at pp. 27-33) provides a helpful table, "Comparison between Original and Revised CAHPS Hospice Survey Items, with Rationale."

Loving Hands Hospice challenges Medicare payment suspension, cites due process concerns amid California hospice enforcement actions TMX Newsfile | Newsfile Corp., Los Angeles, CA; Press Release; 5/19/26 Loving Hands Hospice, a women-owned hospice care provider based in Los Angeles, California, has announced that it is currently involved in a legal dispute connected to Medicare payment suspension measures and related allegations under review (Reference Number: PSP-260330-00042). ... Loving Hands Hospice, which has provided hospice services to patients and families in the Los Angeles area for approximately five years, says it supports enforcement actions where legitimate fraud is identified. However, company leadership states that broad enforcement measures applied across California's hospice sector may not adequately account for differences in individual provider circumstances, patient populations, and compliance histories.

Hawai'i Attorney General rejects characterization of Medicaid fraud enforcement and defends state's enforcement record Hawai'i Free Press, Honolulu, HI; by News Release from Department of the Attorney General; 5/14/26The Department of the Attorney General today rejected recent claims that Hawaiʻi “isn’t taking Medicaid fraud seriously,” calling the claims by Vice President J.D. Vance false and unsupported by the record. Since 2021, the Medicaid Fraud Control Unit (MFCU) has secured or helped secure judgments, settlements and recoveries in 25 cases, totaling $14,094,547.91. Last year, the MFCU secured a $30,000 settlement against a Medicaid provider for fraudulent billing. Earlier this year, the MFCU secured another Medicaid fraud settlement in the amount of $208,317.69. The MFCU also filed criminal charges earlier this year against two individuals, one of whom has already pleaded no contest as charged. [Hawai'i Medicaid Fact Sheet] Editor's Note: This article references "Hawaii's Medicaid coverage for palliative care expected to save the state money," which describes, "Hawaii is the first state to include palliative care in its Medicaid plan."

CMS leader explains hospice fraud, Medicare risks, and the future of healthcare | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Kim Brandt; 5/13/26 In this compelling first installment, CMS Chief Operating Officer and Deputy Administrator Kim Brandt joins Chris Comeaux for a candid conversation about the growing hospice fraud crisis, the financial future of Medicare, and the urgent transformation happening across American healthcare. Drawing from her leadership role at CMS and firsthand experiences with hospice care in her own family, Brandt shares why hospice remains a critical pillar of compassionate care — while also exposing the alarming abuse threatening the integrity of the system.

DOJ doubles down on healthcare fraud enforcement with new West Coast strike force MedCity News; by Katie Adams; 5/10/26 ... The DOJ rolled out a strike force targeting healthcare fraud in Arizona, Nevada and Northern California. The new strike force — which the DOJ is calling its “West Coast” healthcare fraud strike force — comes seven months after the department launched a similar strike force going after healthcare fraud in Massachusetts. Florida is not on this list yet, even though it has a reputation for healthcare fraud, but it might be next. 

Healthcare leaders break down hospice reform, Medicare & quality care | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Tom Koutsoumpas and Carole Fisher; 5/6/26 In Part One of Healthcare Leaders Break Down Hospice Reform, Medicare & Quality Care, Chris Comeaux sits down with nationally respected healthcare leaders Tom Koutsoumpas, Founder & CEO of NPHI and Carole Fisher, President of NPHI to explore the evolving future of hospice, palliative care, Medicare oversight, and the growing demand for quality-driven, compassionate healthcare leadership. Together, they unpack the growing challenges facing end-of-life care — from fraud and benefit manipulation to the urgent need for quality transparency and authentic patient-centered care.

CMS enforcement activity – hospice termination notice CMS.gov - Public Notices; 5/1/26 CMS continues to post Medicare enrollment termination notices for hospices. The most recent posting on May 1, 2026 shows terminations for the last 14 months. Public Notices | CMS