Literature Review

California’s new emergency hospice regulations: key requirements for providers JD Supra; by Margia Corner, Elicia Grilley Green, Lena Zinner; 8/13/26 For the first time in California’s history, hospice agencies have become subject to comprehensive hospice-specific licensing regulations adopted on an emergency basis and effective June 22, 2026. ... The new regulations apply to both existing licensees and new applicants, add significant new requirements for CDPH approval of transactions and other operational changes, such as the licensee’s physical location, and authorize CDPH to conduct unannounced inspections to verify compliance. Providers would benefit from reviewing their operations against the new requirements below.

Can a short-term moratorium strengthen the hospice sector? LeadingAge; by Katie Smith Sloan; 8/11/26 President and CEO Katie Smith Sloan explains why LeadingAge supported the six-month moratorium on Medicare enrollment of new hospice providers and what nonprofit providers can do to strengthen the hospice sector.Earlier this year, I had the opportunity to attend a community theater production of the iconic musical “Fiddler on the Roof.” In a series of unforgettable scenes, Tevye, the production’s main character, makes difficult family decisions by artfully balancing opposing views before choosing his path. “On the one hand,” he intones, then ruminates on the important role tradition must play in the life of his village and family. “On the other hand,” he counters thoughtfully, then acknowledges that the inevitability of change must be factored into every decision.I’ve recalled Tevye’s internal monologue many times since May, when the Centers for Medicare and Medicaid Services (CMS) announced a six-month national moratorium on enrolling new hospice agencies in Medicare. ...

How California’s hospice industry spiraled out of control — and cost millions in fraud Los Angeles Daily News, Los Angeles, CA; by Jason Henry; 8/9/26 A quiet change in California law in 2018 unleashed a deluge of new hospices and spurred millions of dollars in Medicare fraud that state and federal authorities are still trying to unwind. ... It all started with three paragraphs added, at the request of the California Department of Public Health, to the end of an omnibus bill in 2018. CDPH had a backlog of 72 applications for hospice licenses at the time and wanted legislators to provide an alternative to a major bottleneck: its own inspectors. Under SB 1495, hospices could choose to pay a third-party accrediting organization for the inspection needed for a license, instead of waiting weeks or months for the next available state employee. ... Unlike a restaurant, which must undergo fire, building and health inspections, the vast majority of hospices in California could suddenly obtain a license, and even approval to bill Medicare, without a public employee stepping foot on the property. ...

Home health, hospice admissions surge as Medicare Advantage growth plateausMcKnights Home Care; by Marissa Fernandez; 8/6/26  Providers could potentially have a new benchmark for fee-for-service home care admissions, according to the latest report from Trella Health. The annual interactive Post-Acute Market Intelligence Report: 2026 Edition also found increases in home health and hospice admissions, as well as other related data changes that could signal national trends.

Additional CMS website information for the Hospice Wage Index Final RuleCMS 

CMS offers guidance on expanding PACE program to rural areas McKnights Home Care; by Marissa Fernandez; 5/3/26 The National PACE Association praised recent guidance from the Centers for Medicare & Medicaid Services, which offered up mobile health clinics and using funding from the Rural Health Transformation Program as two main ways to expand the Program of All-Inclusive Care for the Elderly to rural areas. ... Mobile health clinics were identified as acceptable alternative care settings as long as they meet applicable local, state and federal health care facility regulations and documentation clearly labels it a mobile unit. CMS also offered guidance to states on using RHT funding for PACE organizations.

Delivering compassionate care in an evolving industry: OIG challengesHospice of the Valley, Phoenix, AZ; Press Release; 8/4/26... Over nearly five decades, Hospice of the Valley-West (HOV-West) has served our community and been a national leader in end-of-life care. We are committed to excellent clinical care along with being strong advocates of regulatory compliance and proponents of responsible stewardship of public resources. This commitment is shown in a number of ways: HOV was ranked among the top three hospices in the nation for high-quality care. ... An OIG third-party contractor audited 100 hospice claims for care provided during the first two years of the COVID-19 PHE. The OIG praised HOV-West for strong internal controls, policies and procedures. During the review, their third-party auditor agreed with 85 records, denying 15 records. In conversation with the OIG, they stated that this represents good results. However, HOV-West strongly disagrees with the 15 denials and we believe they will be overturned through the review and appeal process. ... The OIG report can be read here.

Hospice care in the era of AI: hospices' views on data-driven tools to support live discharge decisionsJournal of the American Geriatrics Society; by Elizabeth A. Luth, Caitlin Brennan, Susan Hurley, Kira G. Sheldon, Yongkang Zhang; 8/3/26 Live discharge occurs for 20% of hospice enrollees, resulting in loss of support and disruptive care transitions, with higher risk for patients with Alzheimer's disease and related dementias (ADRD). Little is understood about how data-driven clinical decision support tools (e.g., predictive algorithms) might support decision making regarding live discharge. ... This paper advances our understanding of multilevel factors hospices face in supporting patients discharged alive. It establishes hospices' interest in adopting data-driven tools to support live discharge and outlines criteria for successful development and implementation of these tools.

Hospice groups ‘disappointed’ by 2027 Final Rule Hospice News; by Jim Parker; 8/3/26 Hospice organizations are expressing “disappointment” following the release of the U.S. Centers for Medicare & Medicaid Services’ (CMS) hospice final rule for 2027. A chief sticking point was the 2.3% base rate increase, which was less than the 2.4% the agency originally proposed. Members of industry trade groups contend that this is an insufficient amount in today’s economy and cost environment. ... New for 2027, the Service and Spending Variation Index (SSVI) includes a scoring system using nine claims-based measures, each representing different aspects of hospice utilization as well as non-hospice spending. This is designed to identify hospices in need of increased transparency and oversight. CMS established the SSVI amid the agency’s concerns over non-hospice spending in particular. The Alliance, LeadingAge and the National Partnership for Healthcare and Hospice Innovation (NPHI) opposed the SSVI in comments on the proposed rule.

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.

National Alliance for Care at Home responds to FY 2027 Hospice Final RuleNational Alliance for Care at Home, Alexandria, VA; Press Release; 7/30/26The National Alliance for Care at Home (the Alliance) today responded to the Centers for Medicare & Medicaid Services (CMS) fiscal year (FY) 2027 Hospice Wage Index and Payment Rate Update final rule, which finalizes payment and regulatory changes under the Medicare hospice benefit. CMS finalized a 2.3% payment update to the Medicare hospice benefit, which continues to fall short of the rising labor and supply costs required to deliver high-quality hospice care. As demand for hospice services continues to grow, payment updates must more accurately reflect providers’ costs so that access to these essential services does not decline.  “CMS’s 2.3% payment update does not reflect the true cost of delivering hospice care and adds further strain to providers who are already stretched thin,” said Jennifer Sheets, CEO of the Alliance. “Compounding that pressure is a Service and Spending Variation Index built on a fundamentally flawed methodology that penalizes legitimate providers for non-hospice claims they have no visibility into nor control over, with no process to review or correct the data before it is made public. This is not a sound approach to program integrity. An inadequate payment update combined with an unreliable oversight tool creates a serious and growing burden for legitimate providers working to serve their communities.” 

Las Vegas Hospice booted from Medicare over ties to sanctioned provider Hoodline; by Christopher Kim; 7/29/26 OneCare Hospice, LLC has been kicked out of Medicare after a federal administrative law judge upheld a government move to cut off the Las Vegas company, not because its own claims were found fraudulent, but because of its legal ties to another Nevada hospice that had already lost its billing privileges. On top of the revocation, OneCare is staring at a 10-year Medicare reenrollment bar and a spot on the Centers for Medicare & Medicaid Services’ Medicare preclusion list. The decision, issued July 9 after OneCare appealed the earlier agency action, found that federal officials were within their rights to pull OneCare’s enrollment.

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.