Policy Issue: Program Integrity

Our Position

Protecting care for patients and families is a top policy priority. We must ensure appropriate oversight and regulation to protect the quality of care hospice patients receive, via additional oversight of new and suspicious hospices to prevent bad actors from operating. 

Resources

Previous Legislation

  • 116th Congress (2019-2020): H.R. 5821: “Helping Our Senior Population in Comfort Environments” (HOSPICE) Act: This legislation would have addressed the concerns identified by the HHS Office of Inspector General about CMS monitoring of hospice, hospice survey deficiencies and patient harm. Provisions of the HOSPICE Act were included and passed within the Consolidated Appropriations Act, 2021 (H.R. 133).  
Policy Alert
Press Release
  • 116th Congress (2019-2020): S.2807: Hospice Care Improvement Act of 2019: This legislation would have included provisions that aim to increase reported hospice data, improve the hospice survey process and increase compliance of quality standards for hospice care.  
Policy Alert
Press Release

Activities

  • September, 2024: The National Alliance for Care at Home worked with McDermott+ to analyze the data limitations and potential errors of the hospice SFP algorithm. The results raised grave concerns over the accuracy of the SFP’s ability to identify the bottom 10% performing hospice providers. Read the summary.
  • September, 2024: Letter from Hospice champions in the House to CMS Administrator Chiquita Brooks-LaSure expressing serious concerns over the design and upcoming implementation of the hospice SFP.
  • August, 2024: Letter from the Alliance to CMS Chief Operating Officer Jonathan Blum requesting a meeting regarding concerns of the hospice SFP’s design and ability to accurately identify poor-performing hospices.
  • July, 2024: Response from the Alliance to Representative Earl Blumenauer’s office after feedback was requested on a draft version of the Hospice CARE Act.
  • May, 2024: Letter from bipartisan Hospice champions in the House to CMS Administrator Chiquita Brooks-LaSure expressing issues with CMS’s lack of information and action addressing criminals abusing the hospice benefit to commit fraud. HAN led efforts on the lobbying, grasstops, and grassroots fronts to rally support for the letter in the House.
  • April, 2024: 2-pager on the issues with this hospice SFP design and the urgent need for action to change it before implementation.
  • March, 2024: Press release from the four preeminent national hospice organizations re: a recent hospice provider survey showing that CMS and Congress must act to address shortcomings in the current hospice audit process.
  • November, 2023: One-Pager from coalition of national hospice organizations listing issues with the hospice SFP design and calling on Congress for specific action to address issues prior to SFP implementation.
  • November, 2023: Press release in opposition to the final Hospice Special Focus Program (SFP) released in the CY2024 Home Health Prospective Payment System Rate Update. HAN launched an action alert, calling on Congress to require CMS to make improvements to the SFP algorithm.
  • October, 2023: Comments in response to Request for Information from the House Budget Committee titled “Solutions to Improve Outcomes and Reduce Federal Health Care Spending in the Budget.” Comments discussed the need for continued policy that addresses hospice fraud.
  • October, 2023: Letter from Congressional hospice champions in the House Ways and Means Committee to CMS and OMB raising concerns about the Hospice Special Focus Program in the FY24 final rule.
  • August, 2023: Coalition Letter to CMS on Auditing of Medicare Hospice Benefit Claims.
  • July, 2023: Congressional champions sent a letter to CMS urging further action on addressing hospice fraud. HAN sent an action alert, encouraging members of Congress to sign on to the letter.
  • June, 2023: Priority Issue at Hospice Action Week 2023 in Washington, D.C.
  • February, 2023: Coalition Meeting with CMS Administrator Chiquita Brooks-LaSure to share concerns and recommendations to address hospice program integrity issues.
  • November, 2022: Coalition Letter to CMS Administrator Chiquita Brooks-LaSure with a collaboratively created list of 34 recommendations to improve hospice program integrity policy and regulation.
  • February, 2020: Priority Issue at We Are Hospice event on Capitol Hill in Washington, D.C.