Complete Story
04/28/2026
Congress Signals Broader Fraud Scrutiny for Hospice and Home Health
Federal scrutiny of Medicare fraud in hospice and home health continues to intensify, with new signals from Congress and regulators that oversight efforts are broadening.
Last week, the House Ways and Means Committee held a hearing focused on Medicare fraud. Testimony highlighted large-scale concerns in certain markets, including testimony that fraudulent activity in some markets may be shifting from hospice into home health.
While these issues have centered largely outside Ohio, the message for providers nationwide is clear: program integrity remains a top federal priority.
For legitimate providers, increased enforcement can still bring operational ripple effects, including added documentation requests, claims scrutiny, referral hesitation, and heightened payer sensitivity.
Why it matters
Ohio hospice and home health providers should expect continued focus on:
- Eligibility and certification accuracy
- Documentation supporting services billed
- Length of stay and utilization patterns
- Ownership, enrollment, and screening processes
- Timely responses to ADRs and audits
Ohio hospices are already familiar with enhanced oversight activity, making proactive compliance more important than ever.
What to do
- Review admissions, recertifications, and face-to-face documentation now
- Confirm billing and clinical records clearly support one another
- Audit long-stay and high-risk claims internally
- Ensure staff know how to route and respond to ADRs quickly
- Stay alert for additional federal actions in hospice and home health