Literature Review

California targeted in House Committee investigation of hospice fraud

Free webinars: Pediatric concurrent hospice care miniseries, guidance for clinicians: A compassionate, coordinated, and compliant approach National Allliance for Care at Home; Press Release; 3/23/26 This Virtual Training will provide a practical, relevant, and comprehensive overview of Pediatric Concurrent Hospice Care as an approach that allows children and adolescents to receive ongoing disease-directed therapies alongside hospice services. Participants will learn the foundations of Concurrent Hospice Care under Section 2302 of the Affordable Care Act including eligibility criteria, planning and coordination requirements, and interdisciplinary collaborative strategies.

CMS Hospice Wage Index Panel: Key insights for access, staffing, and care delivery Abt Global | Centers for Medicare & Medicaid; by Michael Plotzke, T.J. Christian, Matt Knowles, and Anne St. George; meeting held on 9/10/25, report  published 11/24/25The Centers for Medicare & Medicaid Services released both a summary and technical report from its September 2025 Technical Expert Panel on the hospice wage index—offering a closer look at how geographic wage adjustments may evolve. Beyond methodology, the reports carry meaningful clinical and operational implications. Refinements to the wage index influence how resources are distributed across regions, shaping workforce capacity, interdisciplinary team stability, and ultimately patient access to timely, high-quality hospice care. For leaders, these findings underscore the connection between payment policy and bedside realities—particularly in rural and underserved areas where recruitment, retention, and care continuity remain fragile.

HHS and CMS announce Healthcare Advisory Committee members to improve patient care and modernize the U.S. healthcare system CMS Newsroom; Press Release; 3/26/26 The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced the members of the Healthcare Advisory Committee, a new federal advisory body comprised of leaders from across the healthcare system to provide expert advice on improving, strengthening and modernizing U.S. healthcare. The Committee will advise HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz on ways to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. [Access the list]

Medicare Advantage ‘working’ for seniors, but not for taxpayers, experts say: Penn LDI panel cites costs for enrollees alongside billions in overpayments and systemic gaming Penn LDI - Leonard Davis Institute of Health Economics; by Hoag Levins; 3/23/26 In response to the question “Is Medicare Advantage Working?” posed in a University of Pennsylvania panel discussion, two top experts concurred that the program is “working” in one narrow but powerful sense: It delivers more appealing coverage to many seniors, especially those with modest incomes. But it is not “working” in the sense originally promised by policymakers, because it is not saving public money and has encouraged a range of payment distortions, coding games, marketing excesses, and utilization-management conflicts.

CMS clarifies hospice revocations, face-to-face encounters McKnights Home Care; by Suzy Frisch; 3/24/26 If a hospice patient is discharged from care or has their benefits revoked, they do not have to complete a waiting period to arrange for new care, according to the Centers for Medicare & Medicaid Services, which provided such clarifications earlier this month. If a hospice patient is discharged from care or has their benefits revoked, they do not have to complete a waiting period to arrange for new care, according to the Centers for Medicare & Medicaid Services, which provided such clarifications earlier this month. 

NPHI calls on CMS to enact temporary nationwide moratorium on new hospice provider enrollments to stop fraudulent operators National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 3/25/26 The National Partnership for Healthcare and Hospice Innovation (NPHI), representing the nation’s leading nonprofit, mission-driven, safety-net, hospice and advanced illness care providers, is calling on the Centers for Medicare & Medicaid Services (CMS) to implement a temporary, nationwide moratorium on new hospice provider enrollments in response to the continued growth of fraudulent providers exploiting the Medicare hospice benefit. In a letter sent today to CMS Administrator Dr. Mehmet Oz and Deputy Administrator Kimberly Brandt, NPHI outlines concerns regarding the unchecked expansion of fraudulent hospice providers and the impact on patients, families, and the integrity of the Medicare program.

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. 

15 hospices incorporated in a single day, in a single suite in Van Nuys Daily Breeze; by Jason Henry; 3/22/26 A group operating out of a Friar Street office building in Van Nuys that advertises “virtual offices” incorporated 22 hospices and home care agencies in one year, including 15 hospices registered in one day to a single suite, according to an investigation by the Southern California News Group. The 15 hospices, all formed in “Suite 205” at 14545 Friar St., later collected $12.3 million from Medicare and Medi-Cal billings in 2023 and 2024, records showed. ... While operating out of the same building is permitted, hospices cannot use the same office, according to Sheila Clark, the president and CEO of California Hospice and Palliative Care. ... She’s been sounding the alarm about fraud risks in Los Angeles’ hospice industry for years now. ...However, these hospices seemingly bypassed that limitation by appending letters from “A” to “P” onto the suite number in official documentation.

What is the quality of care at the end of life? Qualitative findings from a nationally-representative post-bereavement survey across England and Wales Journal of Health Services Research & Policy | University of Cambridge; by Joanna Goodrich Sophie Pask, Chukwuebuka Okwuosa, Therese Johansson, Lynn Laidlaw, Cara Ghiglieri, Rachel Chambers, Anna E. Bone, Stephen Barclay, Fliss E. M. Murtagh, Katherine E. Sleeman; 3/13/26 ... Our aim in this study was to explore the quality of end-of-life care in England and Wales using the experiences of bereaved family carers, and to develop person-centred quality of care domains for end-of-life care. ... Six themes were identified in relation to the quality of care for those with advanced illness and their family carers. 

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. 

CMS implements enhanced oversight for MAC MBI lookup tools Hospice News; by Jim Parker; 3/17/26 ... In response to a rise in these fraudulent activities, CMS has strengthened oversight of Medicare Administrative Contractor (MAC) MBI lookup tools. The agency now monitors MBI searches against submitted claims using National Provider Identifiers (NPIs). Access to these tools may be revoked if providers conduct a high volume of lookups without submitting corresponding claims. This move by CMS is likely an important step in combatting fraud, according to Sheila Clark, president and CEO of the California Hospice and Palliative Care Association (CHAPCA).