Literature Review

In fight against fraud, leading national organizations urge CMS to take action while protecting legitimate providers and patient access The National Alliance for Care at Home (the Alliance); Press Release; 3/25/26The National Alliance for Care at Home (the Alliance), LeadingAge, LeadingAge California, and the California Association for Health Services at Home (CAHSAH) in a March 25, 2026 letter to Dr. Mehmet Oz, Administrator, ​the ​Centers for Medicare and Medicaid Services (CMS), commend the agency’s actions to protect Medicare beneficiaries, preserve the integrity of the hospice and home health benefits, and root out bad actors who are exploiting the program and harming patients and families. At the same time, the associations emphasize the need for a carefully targeted federal response to protect current and prospective patients, and preserve access to care delivered by trustworthy providers.

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. 

CMS looks to kill the fax machine McKnights Long-Term Care News; by Kimberly Marselas; 3/23/26 The Centers for Medicare & Medicaid Services is moving forward with a interoperability rule that aims to “eliminate” faxing and replace it with universal electronic healthcare claims and documentation exchanges by mid-2028. ... While it applies to all providers covered by the Health Insurance Portability and Accountability Act, including health plans, the new rule could strike fear among the many nursing homes still reliant on faxing or other manual communication methods for referrals and approvals.

Oversight Committee launches investigation into rampant taxpayer fraud in California hospice programs U.S. Committee on Oversight and Government Reform, Washington, DC; Press Release; 3/23/26Following alarming reports that California officials failed to properly safeguard federal funds, House Committee on Oversight and Government Reform Committee Chairman James Comer (R-Ky.) and Oversight Committee Republicans today launched an investigation into rampant taxpayer fraud in California’s hospice programs. In a letter to California Governor Gavin Newsom, the lawmakers emphasized that the Newsom administration has been aware of state audit reports of hospice fraud for at least four years but has failed to prevent or detect it and has enabled hospice providers to defraud the American taxpayer and exploit vulnerable patients. The Oversight Committee is now requesting documents and communications regarding California’s oversight and internal controls to detect and prevent fraud for its federally funded hospice programs.

AMGA calls for total-cost-of-care model for end-of-life care Healthcare Innovation; by David Raths; 3/20/26 Among the recommendations of a value-based care task force of the American Medical Group Association (AMGA) is that CMS should establish a total-cost-of-care model for end-of-life care. AMGA  is a trade association representing multispecialty medical groups and integrated systems of care. More than 175,000 physicians practice in its member organizations. Editor's Note: Download the AMGA's 44-page Task Force Recommendations. It details these six foundational pillars they identified:

Ahead of National Volunteer Month, NPHI calls on Americans to become hospice volunteers and strengthen human connection National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 3/19/26 As more Americans look for ways to build connection and find purpose in their communities, the National Partnership for Healthcare and Hospice Innovation is encouraging individuals to consider volunteering with their local hospice during National Volunteer Month this April. Across the country, nearly 30,000 volunteers already serve alongside professional care teams within NPHI's network of more than 125 nonprofit providers, bringing comfort, presence, and human connection to patients and families facing serious illness while also experiencing the personal benefits of giving back.

Most newly enrolled California hospice agencies flagged for fraud, CMS says Washington Examiner; by Mia Cathell; 3/18/26 A top official at the Centers for Medicare & Medicaid Services informed Congress on Tuesday that federal investigators have stripped billing privileges from three-fifths of newly enrolled hospice agencies that have continued to pop up in California, a state long riddled with healthcare fraud. Of the remaining California-based hospice service providers that emerged over the past six months, 35% were flagged for corrective action, Kimberly Brandt, the chief operating officer of CMS, told the House Energy and Commerce Subcommittee on Oversight and Investigations.

Report: Over 40% of hospice centers in L.A. County ‘show multiple indicators’ of fraudulent activity One America News; by Addie Davis; 3/13/26 Over 700 of the roughly 1,800 hospice agencies in Los Angeles County show multiple state identified indicators of fraud, according to an analysis by CBS News. A 2022 California state audit highlights a staggering 1,500% surge in hospice agencies since 2010. By 2019, Los Angeles County’s density of hospice centers reached six and a half times the national average relative to its elderly population — a saturation point linked to an estimated $105 million in Medicare overbilling, according to CBS News.

Hospice nurse weekend visit rates, by state Becker's Hospital Review; by Elizabeth Gregerson; 3/11/26 ... CMS collects skilled nursing visit data, submitted directly by hospice providers, from Medicare hospice claims, and from the Hospice Consumer Assessment of Healthcare Providers and Systems survey, through the Hospice Quality Reporting Program. The national percentage of hospice nurse visits provided during the weekend was 9.6%. Here are the percentage of weekend skilled nursing minutes provided between Jan. 1, 2023, and Dec. 31, 2024, by state, according to CMS: ...

2025 Facts and Figures Report now available to Alliance members The National Alliance for Care at Home; Alexandria, VA and Washington, DC; Press Release; 3/3/26 The National Alliance for Care at Home (the Alliance) published the 2025 edition of Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, hospice provider characteristics, and quality of care. Facts and Figures – the leading resource for hospice providers and others interested in understanding the work of the community – has been published annually for over two decades. The findings in this report reflect patients who received care in 2024, provided by hospices certified by the Centers for Medicare & Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. ... The full 2025 Facts and Figures report is available for Alliance members online. The Executive Summary is available to the public.  Editor's Note: Pair this national data with the The Alliance and the Research Institute for Home Care release 2025 Hospice Chartbook that we posted on 2/20/26. The RIHC Hospice Chartbook mainly provides state views with some national treands, whereas this Facts and Figures report is mainly a national view with time trends.

The measure isn’t wrong. The story is incomplete. McKnights Long-Term Care News; by Steven Littlehale; 2/27/26 Not long ago, I was sitting across from a nursing home leadership team as they stared at a quality measure report that didn’t make sense to them. ... So we did what more facilities should do when a QM score feels off: We stopped looking at the rating and started looking at the math. That’s where the real story surfaced. It wasn’t about poor care, but about exclusions not captured, covariates not fully coded, and pieces of the clinical picture that never made it into the structured data fields the Centers for Medicare & Medicaid Services reads. 

Husch Blackwell’s Meg Pekarske: Hospices facing ‘huge pendulum shift' Hospice News; by Holly Vossel; 2/27/26 The hospice space has seen waves of regulatory changes in recent years that are affecting sustainable access, according to Meg Pekarske, partner at the law firm Husch Blackwell. Ensuring program integrity and quality will take an overhaul of hospice regulation. Pekarske, a hospice and health care attorney, is retiring with more than 25 years of legal experience, effective March 31. She recently sat down with Hospice News to reflect on the most significant regulatory changes impacting the future scope of hospice care delivery. Greater consideration is needed around a potential revamp of the Medicare Hospice Benefit, Pekarske said.

Medicare, Medicaid, and Children's Health Insurance Programs: Nationwide Temporary Moratoria on enrollment of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier medical supply companies Federal Register; by the Centers for Medicare & Medicaid Services; 2/27/26 Summary: This notice announces the imposition of a 6-month nationwide moratorium on the Medicare enrollment of DMEPOS supplier medical supply companies. Background: ... Under the Patient Protection and Affordable Care Act (Pub. L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152) (collectively known as the Affordable Care Act), Congress provided the Secretary with new tools and resources to combat fraud, waste, and abuse in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).