Federal attention on hospice and home health program integrity continues to escalate, but providers are now pushing for a more balanced and targeted approach to enforcement.
In a March 25 letter to CMS, LeadingAge, the National Alliance for Care at Home, and other national partners commended the agency’s efforts to address fraud while urging policymakers to avoid broad enforcement strategies that could unintentionally impact compliant providers.
The letter emphasizes that while fraud remains a serious issue, it is largely driven by a small subset of bad actors, not the broader hospice and home health community. Providers cautioned that overly aggressive or unclear enforcement could create unintended consequences, including delayed referrals, reduced access to care, and increased administrative burden for legitimate organizations.
This comes as federal scrutiny continues to intensify, including investigations into hospice fraud in high-risk regions and expanded oversight tools such as prepayment review and enhanced enrollment screening. National experts have also raised concerns that current enforcement approaches may lack transparency and could pull compliant providers into audit activity.
Why it matters
Federal enforcement is not slowing down, but how it is implemented matters. Ohio providers are already operating under increased scrutiny, and this national conversation signals continued focus on:
At the same time, there is growing recognition at the national level that enforcement must be risk-based and targeted to avoid disrupting access to care.