Literature Review

Trellis Supportive Care supports CMS efforts to strengthen hospice oversight The Stokes News, Winston Salem, NC; by Ann Gauthreaux; 6/3/25 [Background information about the CMS Hospice six-month moratorium] “Hospice care should always represent dignity, compassion, and trust,” said Dr. Mike Lalor, CEO of Trellis Supportive Care. “Actions that address bad actors in our industry are necessary to preserve the integrity of hospice and ensure that patients receive the quality care they deserve.” Trellis Supportive Care wants to reassure patients, families, referral partners, and the broader community that this moratorium does not impact its services or operations. The organization continues to provide hospice, palliative, and supportive care throughout the region without interruption.

CMS releases guidance to surveyors on hospice, home health moratoria LeadingAge; Press Release; 6/2/26 The Centers for Medicare and Medicaid Services (CMS) released guidance to surveyors regarding the home health and hospice moratoria which took effect May 13, 2026. While much of the information is consistent with the previous FAQs released by CMS, the memo does note that if a presidential disaster is declared, the moratoria will be lifted. Additionally, the memo makes clear that during the moratorium, accreditation from an approved accrediting body cannot serve as the basis for Medicare participation.

Hospice advocates push back on CMS’ proposed program integrity scoring system McKnights Home Care; by Liza Berger; 6/3/26 In recent comments to the Centers for Medicare & Medicaid Services, hospice advocates criticized the new scoring system, the Service and Spending Variation Index, or SSVI, that CMS put forth in its fiscal year 2027 hospice proposed rule in April to curb fraud in the sector. They cited a flawed methodology underlying the scores and called for CMS to take down two years of publicly posted data. ...The National Alliance for Care at Home pointed to inaccurate scoring in publicly posted data. “This data could cause substantial reputational harm to hospices for mistakes made by CMS in file construction and assigning scores,” Jennifer Sheets, CEO said.LeadingAge said the nonhospice spending measure “lacks transparency, disregards the influence of size and scale, includes questionable data, and is entirely inactionable for hospices.” Such a measure could target the wrong providers, LeadingAge argued. Editor's Note: Explore details from The Alliance, LeadingAge, and NPHI.

FBI Public Service Announcement: Emerging hospice fraud targeting Medicare recipients Federal Bureau of Investigation (FBI); Public Service Announcement, Alert Number I-060326-PSA; 6/3/26 The Federal Bureau of Investigation (FBI) is issuing this Public Service Announcement to warn the public of an emerging hospice fraud scheme that targets vulnerable Medicare recipients who are not in need of hospice services. Scammers are enrolling Medicare patients in hospice care for services they do not need or for services that are not provided. ... Tips to Protect Yourself:

A month’s worth of fraud busting in 10 notable quotesHealthExec; by Dave Pearson; 5/26/26This month, HHS’s Senior Medicare Patrol program designated the first workweek of June Medicare Fraud Prevention Week... Ahead of June 1 to 5, here’s a timeline of fraud-related news, views and developments as captured in concise statements uttered or written in May. [See article for all 10 quotes.]

CMS reportedly unresponsive to hospice payment suspension rebuttals Hospice News; by Jim Parker; 5/29/26 The U.S. Centers for Medicare & Medicaid Services (CMS) has been largely unresponsive to hospices’ rebuttals to payment suspensions due to suspicion of fraud. Legitimate hospice providers are being swept into CMS’ broader fraud crackdown, with some agencies reportedly facing payment suspensions severe enough to force closures. ... Hospice News has spoken with 10 hospices that have received suspension letters; each indicated that the block on their payments was based on a single metric — live discharges. Suspended hospices have the ability to file a rebuttal seeking to have the payment freeze reversed. However, to date, few hospices have received any response from CMS or its Unified Program Integrity Contractors (UPIC).

NMAHHC supports efforts to combat fraud — warns against unintended harm to patient access Roswell Daily Record, Albuquerque, NM; Press Release; 5/28/26 The New Mexico Association for Home & Hospice Care (NMAHHC) expressed support for federal efforts to address fraud and abuse within the Medicare home health and hospice programs ... However, the association urges policymakers and regulators to ensure enforcement efforts remain targeted and evidence-based so compliant providers and vulnerable patients are not harmed in the process.

Van Duyne introduces the Protecting Seniors and Stopping Fraudsters Act to enact Mandatory oversight requirements to combat hospice and home healthcare fraud Congresswoman Beth Van Duyne, Washington, DC; Press Release; 5/19/26 ... Since 2023, Rep. Van Duyne (TX-24) has been a recognized leader on the issue of exposing and stopping hospice and home healthcare fraud. ... This week, Rep. Van Duyne introduced new legislation, the Protecting Seniors and Stopping Fraudsters Act, to strengthen Medicare oversight, crack down on bad actors, protect seniors from fraudulent enrollments, and improve accountability across the hospice and home health system. ...Summary and Key Provisions: This legislation is a targeted Medicare program integrity package focused on cracking down on hospice and home health fraud while protecting legitimate providers and patient access. The bill is designed to move Medicare oversight from a reactive model to a proactive one by identifying bad actors earlier, particularly in geographic hotspots where provider growth far exceeds patient growth. It targets providers with aberrant billing, discharge, enrollment, or low-quality reporting patterns rather than imposing blanket burdens across the industry. [Continue reading]

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.”

HealthView CEO Steven Gonzalez announces Inc. articles on why presence beats certainty — and why it matters even more in the age of AI Associated Press, Cerritos, CA; 5/19/26 Steven Gonzalez, President & CEO of HealthView Home Health, Hospice & Palliative Care, announces the publication of his latest Inc. article, “Certainty Is Overrated. Presence Is Underrated,” now live on Inc.com. ... In the published article, Gonzalez challenges a long-held leadership myth: that strong leaders must always project confidence, clarity, and absolute answers. Instead, he makes the case that presence, consistency, and authenticity matter more than false certainty in times of rapid change. When leaders remain visible, grounded, and human, they build the trust and stability that carry teams forward — even in the middle of ambiguity.

Maui Hospice calms jitters after feds freeze new Medicare sign-ups Hoodline; by Marc Suzuki; 5/20/26Hospice Maui moved quickly this week to calm worried island families after federal officials hit pause on new Medicare hospice and home health enrollments. The Wailuku nonprofit stressed that long-standing, Medicare-certified providers like itself are not the focus of the federal action, and that patients already in its care will continue to receive visits, medications and support services without interruption. The organization also pointed families to a direct phone line for anyone who wants a real person to walk them through what the freeze does and does not mean.

Loving Hands Hospice challenges Medicare payment suspension, cites due process concerns amid California hospice enforcement actions TMX Newsfile | Newsfile Corp., Los Angeles, CA; Press Release; 5/19/26 Loving Hands Hospice, a women-owned hospice care provider based in Los Angeles, California, has announced that it is currently involved in a legal dispute connected to Medicare payment suspension measures and related allegations under review (Reference Number: PSP-260330-00042). ... Loving Hands Hospice, which has provided hospice services to patients and families in the Los Angeles area for approximately five years, says it supports enforcement actions where legitimate fraud is identified. However, company leadership states that broad enforcement measures applied across California's hospice sector may not adequately account for differences in individual provider circumstances, patient populations, and compliance histories.