Literature Review

CMS creates new health tech office to lead interoperability efforts, digital products Fierce Healthcare; by Heather Landi; 6/15/26 The Centers for Medicare and Medicaid Services (CMS) aims to play a bigger role in health tech modernization efforts, including leading interoperability initiatives. The agency created a new Office of Health Technology and Products (OHTP) to provide "enterprise leadership and oversight for CMS healthcare technology modernization, digital products and transformation of platforms and services supporting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and other CMS-administered programs," according to a notice in the Federal Register published on June 11. The new health tech-focused office will work in close coordination with the CMS Chief Information Officer (CIO) and will lead enterprise strategy for artificial intelligence, interoperability, digital product development, Medicare.gov, provider directories and claims system modernization, according to the notice. The office consists of eight divisions and the notice lists more than 90 responsibilities.Editor's Note: Examine the detailed Federal Register's "Statement of Organization, Functions, and Delegations of Authority"

CMS proposes community-based palliative care benefit Hospice News; by Jim Parker; 7/1/26 The U.S Centers for Medicare & Medicaid Services (CMS) has proposed coverage of community-based palliative care through the Medicare home health benefit. CMS included the palliative benefit in its 2027 proposed home health rule. ... The agency emphasized that palliative care under the home health benefit would be separate from hospice care and could support patients earlier in the course of serious illness.

Hospice Medicare suspension or Medicaid suspension? Your seven next steps The National Law Review; by Dr. Nick Oberheiden, PC; 6/25/26 ... What Hospice Care Providers and Home Health Agencies Should Do When Facing Medicare or Medicaid Payment Suspensions ...

National health care fraud takedown results in 455 defendants charged in connection with over $6.5 billion in alleged fraud Office of Public Affairs - U.S. Department of Justice, Washington, DC; Press Release; 6/23/26Record Medicaid Fraud Charges Largest Number of States Participating in Health Care Fraud Takedown History: The Justice Department today announced the 2026 National Health Care Fraud Takedown, which resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death. Today’s Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history.

Northern District of Texas charges 13 health care fraudsters for loss over $360 million United States Attorney's Office | Northern District of Texas; Press Release; 6/23/26 Thirteen defendants were among those charged in the Northern District of Texas as part of the 2026 National Health Care Fraud Takedown, announced United States Attorney for the Northern District of Texas Ryan Raybould, during a press conference held earlier today. The charges announced today ... resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death. Today’s Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history.

Medicare could have saved $255.1 Million related to hospice services for certain new hospice enrollees United States Government HHS-Office of the Inspector General (OIG), Report number: A-06-22-09003; issued on 6/18/2026, posted on 6/23/26 [From the Full Report]: Our objective was to determine whether the Centers for Medicare & Medicaid Services (CMS) made Medicare payments to hospices for certain new hospice enrollees in accordance with Medicare requirements.

Somerset hospice opening delayed by Medicare move The Tribune-Democrat, Somerset, PA; by Kelly Urban; 6/20/26 Following a ribbon-cutting in May for the reopening of the Somerset inpatient hospice facility, Windber Hospice at Chan Soon-Shiong Medical Center at Windber has provided an update regarding the facility’s opening timeline. While the facility remains on track to reopen, the opening has been delayed by a recently announced nationwide Medicare enrollment moratorium affecting new hospice enrollments and hospice locations. ... “We know many families have been eagerly anticipating the return of inpatient hospice care in Somerset County, and we share their disappointment in this unexpected delay,” said Richard Sukenik, CEO of Chan Soon-Shiong Medical Center at Windber. “We are actively working with local, state and federal legislators to seek assistance and ensure they understand the importance of bringing this service back to Somerset County. We will continue pursuing every available avenue to move this project forward while preparing to welcome patients as soon as approval is granted.” [Access to the full article may be limited by a paywall.]

CMS proposed rule locks in lower prices and fosters innovation for the Medicare Drug Price Negotiation Program CMS.gov; Press Release; 6/12/26 A new proposal from the Centers for Medicare & Medicaid Services (CMS) would establish a permanent framework for the Medicare Drug Price Negotiation Program (“Negotiation Program”), creating a more transparent and sustainable process for lowering drug costs for millions of Medicare beneficiaries. The proposed rule would also create greater long-term certainty for drug manufacturers that participate in negotiations. It includes policies for negotiating and renegotiating high-cost, single-source drugs beginning with initial price applicability year 2029, while continuing to support innovation and strengthen the program.

HOPE Tool transition fraught with challenges, may be better than past federal initiatives  Hospice News; by Jim Parker; 2/17/26 Implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool has gone smoothly for some providers, but challenges persist. Some stakeholders also say that this new system doesn’t capture the full scope of hospice quality. At VITAS Healthcare, a subsidiary of Chemed Corp. (NYSE: CHE), the transition to HOPE has gone well compared to past federal initiatives, according to CEO Joel Wherley. However, the ultimate results remain uncertain.

Medicare’s Part A Trust Fund is projected to run short in 2033: 6 costs seniors should watch SavingAdvice; by Drew Blankenship; 6/16/26 ... Recent reports project that Medicare’s Part A Trust Fund could start to run short in 2033, meaning it will be unable to cover 100% of its obligations by that time. ... While Medicare isn’t going to disappear, here are six costs seniors should keep a close eye on.

Vance’s fraud task force is sweeping up legitimate small businesses The Washington Post, Washington, DC; by Isaac Arnsdorf; 6/15/26 The vice president and other officials have downplayed evidence of collateral damage in their crackdown on fraudulent hospices. In April, when the Trump administration began suspending about 800 hospices in the Los Angeles area suspected of fraud, a small local agency started accepting patients from the affected providers. The owner never thought he would be next. ... “The Trump administration is taking a pretty aggressive tactic here, but the downside is you’re often going to catch up legitimate actors because you’re not really taking the time to do your due diligence,” said Hillary Loeffler, vice president of policy and regulatory affairs for the National Alliance for Care at Home, an industry group, who worked on hospice issues at CMS until 2025.

CMS moratorium could spur hospice, home health M&A Hospice News; by Jim Parker; 6/12/26 A current moratorium on home health and hospice Medicare enrollment could increase demand for mergers and acquisitions in the short term. ... The pause is intended to address concerns about a surge in new providers that regulators have linked to fraudulent activity in the hospice sector. ... Rumors have circulated that the moratorium could be extended beyond the six months, though to date CMS has given no indication that will be the case. The moratorium could limit provider growth via de novos, so some companies may turn towards more M&A, according to Cory Mertz, managing partner of the M&A advisory firm Mertz Taggart.

CMS home health and hospice moratoria update: emerging guidance and enforcement update JD Supra; by Christina Bergeron, Lauren Biggs, Robin Briendel; 6/10/26 This Alert discusses [developments since the May 13th CMS home health and hospice moratoria], as well as related state Medicaid and licensure activity, increasing enforcement activity, and recent federal legislative developments affecting the hospice and HHA sectors.