Volume 26.07
On May 20, 2026, the “Protecting Seniors and Stopping Fraudsters Act” (“ACT”) was introduced in the House of Representatives.
The proposed legislation, if enacted, would provide:
- Increased survey frequency for newly enrolled hospices and home health agencies, providers with ownership changes, or providers displaying signs of fraudulent behavior.
- Enhanced screening requirements for providers deemed at “extreme risk” of fraud, including fingerprinting administrators and medical directors and requiring proof of liability insurance.
- Greater accountability for accrediting organizations through standardized survey training requirements.
- New beneficiary notification requirements to ensure seniors know when they have been enrolled in hospice and understand how to disenroll if fraud or abuse occurs.
- Annual reporting to Congress on CMS program integrity activities, enforcement actions, fraud trends, and efforts to reduce unnecessary administrative burden on legitimate providers.
The proposed legislation is available here.
The increased survey frequency requirements would also apply to those hospices failing to submit quality data and those that have a higher live discharge rate as determined by the Secretary of Health and Human Services (“Secretary”).
Additionally, the ACT would cause a 15% reduction to Medicare payments for those hospices failing to submit quality data. Currently it is estimated that up-to 20% of hospices fail to submit the required data.
APPLICATION OF HOSPICE ENROLLMENT MORATORIUM
We are already receiving numerous questions regarding the recently imposed enrollment moratorium on hospices and home health agencies.
The moratorium does not apply to:
- Reporting changes in enrollment information unless the enrollment change relates to adding a new location, and
- Reporting a change in ownership that complies with the 36-month rule.
2026 HOSPICE FINANCIAL AND COMPLIANCE MANAGEMENT CONFERENCE
The Health Group, LLC will be sponsoring the “2026 Hospice Financial and Compliance Management Conference” on October 1-2, 2026, in Las Vegas. It has been several years since The Health Group, LLC has held a program in Las Vegas, and we are excited to again provide attendees with a quality program in this location. We have selected Paris Las Vegas as the venue for the program, and we have secured discounted rates for Tuesday, September 29, 2026, through Saturday, October 3, 2026.
The program will have significant focus on the fraud and abuse efforts currently underway and anticipated, as well as critical fiscal management issues for hospices.
Mark your calendars for October 1-2, 2026. Additional details are forthcoming. Make certain to obtain information as early as possible by emailing us at conference@healthgroup.com.