Literature Review

NPHI submits comments on FY 2027 Hospice Proposed Rule, urges CMS to strengthen transparency, support access, and advance meaningful reform  National Partnership for Healthcare and Hospice Innovation, Washington, DC; Press Release; 6/2/26The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for nonprofit hospice and advanced illness care, has submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) regarding the Fiscal Year (FY) 2027 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements proposed rule. In the letter, NPHI welcomed CMS’s continued engagement with hospice stakeholders and offered detailed recommendations designed to strengthen patient access, improve transparency, reduce unnecessary administrative burden, and support high-quality, community-based hospice and palliative care. 

Ohio toughens Medicaid fraud prevention with new initiatives Epstein Becker Green Law; by Ann Parks; 5/29/26 On May 13, 2026, Ohio Governor Mike DeWine announced new Medicaid fraud prevention initiatives focusing on home health and hospice providers from the Ohio Department of Medicaid (ODM). Governor DeWine also issued an Executive Order on May 18, 2026, directing new emergency rules for multiple provider enrollment enforcement actions including revalidations of identified high-risk providers.

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.   

Get ready to access the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER)CMS Center for Program Integrity; 5/28/26 CPI is getting really close to releasing the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER). The Hospice PEPPER will be available through the PEPPER Portal in early June 2026. To ensure hospice providers can successfully access their reports, we ask that you distribute the following instructions to your members.

CMS targeting Georgia, Ohio in fraud fight Hospice News; by Jim Parker; 5/22/26 Ohio and Georgia are seeing a large influx of new hospice operators, leading some to suspect that fraud is becoming more prevalent in those states. The four states that historically have been hotbeds for fraud — California, Arizona, Nevada and Texas — also saw hosts of new providers enter their markets, many of which were malfeasant. Among other efforts to combat the ongoing fraud, the U.S. Centers for Medicare and Medicaid Services (CMS) in 2023 instituted a provisional period of enhanced oversight for those four states. That has now been extended into Georgia and Ohio, retroactive to Dec. 31, 2025.

CMS clarifies telehealth policy during enrollment moratorium Hospice News; by Jim Parker; 5/21/26 Hospices will continue to be able to use telehealth for face-to-face recertifications during the hospice and home health enrollment moratorium, according to the U.S. Centers for Medicare & Medicaid Services’ (CMS). ... The federal statute stipulates that telehealth recertifications are not permitted in regions that are under an enrollment moratorium. This has raised some questions about how hospices can use telehealth for the next six months. “Perhaps the most troubling unintended consequence of a nationwide moratorium is its apparent impact on telehealth …” a trio of state associations said in a joint statement. “In rural communities and congested urban areas alike, this imposes severe and unnecessary burdens on the most vulnerable patients at the most vulnerable moments of their lives.”

The state of hospice: Impacts on equity, quality, and nursing-An AAN consensus paperNursing Outlook; by Laura Fennimore, Kathleen O Lindell, Marjorie M Godfrey, Melissa Reider-Demer, Patrick J Coyne, Ronda G Hughes, Sharon Kozachik, Masako Mayahara, Patricia L Thomas, Nelson Tuazon, Polly Mazanec; 4/26Hospice care has been an integral component of the United States healthcare system for over fifty years. Hospice has transitioned from a volunteer activity supported by philanthropy to a highly sophisticated business funded by Medicare, increasingly offered by for-profit and private equity companies. This consensus paper examines the current state of hospice care in the US and the impact of changing hospice business models on health equity, healthcare quality, and nursing practice. Recommendations include updating policies to account for private equity involvement, evaluating current quality measures, addressing the existing Medicare Hospice Benefit, ensuring transparency and oversight for hospice agencies, and ensuring patient and caregiver education about hospice services. These recommendations aim to preserve the fundamental values of hospice, supporting compassion, dignity, and comfort while ensuring the quality of care to patients and families in need.

Background on CMS’s anti-fraud efforts in hospice careAEI - The American Enterprise Institute; by James C. Capretta; 5/21/26 ... For broader context, Congress added hospice coverage to Medicare in the 1980s to provide lower-cost and more patient-centered settings for terminally ill beneficiaries. ... Like home health, the hospice benefit is vulnerable to abuse because the barriers to entering the market are lower than in more regulated settings. The capital investment to get started is minimal in comparison with building a new hospital, outpatient clinic, or nursing home. Further, the potential profit margins are high if a service provider is confident that the per diem is above what is needed to provide the required services.Although CMS’s focus on fraud in hospice care is warranted, stronger oversight by itself may not produce large program savings. In theory, more use of hospice care could lead to lower overall costs if the sponsoring agencies are competent and can help their patients avoid costly hospital or nursing home admissions. CMS’s investigations need to be subtle enough to weed out the bad actors without making it overly difficult for vulnerable patients to get the care they need in their own homes or in other low-cost community settings.

CMS’s nationwide moratorium on new hospice and home health enrollments: operational, transactional, and enforcement risks for existing providers, healthcare organizations, and investorsClark Hill; by Jose Vela Jr.; 5/19/26 ... Key Takeaway: The larger issue may no longer be whether fraud exists within isolated hospice or home health agencies. ... Healthcare organizations, investors, healthcare professionals, and operational leaders affiliated with hospice and home health providers may wish to evaluate ownership structures, pending transactions, enrollment status, billing practices, referral relationships, operational controls, reimbursement exposure, and existing government scrutiny before operational disruptions, payment suspensions, recoupment activity, or enforcement actions arise.

Ohio taking new steps to target Medicaid fraud Spectrum News 1, Cleveland and Columbus, OH; by Aliah Keller; 5/14/26Ohio is taking new steps to crack down on Medicaid fraud, with a focus on home-healthcare and hospice providers.What You Need To Know

The National Law Review: CMS imposes nationwide enrollment moratoria on hospices and home health agencies - what buyers sellers and operators need to know The National Law Review; by Margia Corner, Ashley Wheelock, Tammy Ward Woffenden, Sheppard, Mullin, Richter & Hampton LLP; 5/14/26 ... [Assuming readers have background information] ... Critically for some pending or proposed transactions, both moratoria block re-enrollment of hospices or HHAs undergoing a non-exempt change in majority ownership (CIMO) within 36 months of initial enrollment or the most recent CIMO. Such transactions require the entity to enroll as a brand-new provider.... Both moratoria apply only to Medicare. However, CMS is encouraging states to consider parallel moratoria for Medicaid and CHIP, tailored to their beneficiary population and geographic considerations. CMS also noted that while some states previously enacted laws placing a moratorium on issuing new licenses in their state, those efforts cannot prevent new agencies or enrollments in other states and thus its nationwide moratoria are warranted.

PARC Retreat explores how aging, workforce strains, and federal debt are reshaping U.S. health care Penn LDI - Leonard Davis Institute of Health Economics; by Hoag Levins; 5/13/26 Penn Gathering of Experts Examines the Growing Pressures Facing Older Americans In predicting the future of U.S. health care, it is important to recognize that the long-term health of the population depends not just on medical policy, innovation, or care delivery, but on whether the federal government can sustainably finance the systems that pay for that care, Penn Wharton School Professor and national budget expert Kent Smetters, PhD, told the May 1, 2026 Penn Population Aging Research Center Annual Retreat.