06/04/2026

Hospice Integrity Reforms Advance Through House, Added to Broader Medicaid Package

A hospice integrity initiative developed by LeadingAge Ohio and championed by Rep. Andrea White (R-Kettering) took two major steps forward Wednesday, receiving its first hearing in the House Health Committee before being incorporated later that day into the House's broader Medicaid anti-fraud legislation, HB 795, known as the SHIELD Act.

The developments significantly increase the likelihood that key hospice oversight and transparency reforms will advance this session.

HB 945 was introduced following months of work led by LeadingAge Ohio in collaboration with hospice providers, regulators, policymakers, and industry stakeholders. After discussions with LeadingAge Ohio about growing concerns surrounding hospice oversight and quality, Rep. White agreed to sponsor and champion the legislation, working closely with stakeholders to refine the proposal and move it through the legislative process.

During sponsor testimony, White said the bill is intended to strengthen oversight, increase transparency and accountability, and help patients and families identify high-quality hospice providers they can trust.

White noted that Ohio was added to the Centers for Medicare & Medicaid Services' Enhanced Oversight Program in late 2025 and pointed to the rapid growth of hospice providers across the state. Citing information from LeadingAge Ohio, she noted that much of that growth has occurred in already saturated metropolitan markets rather than in underserved rural communities.

"LeadingAge had been collecting input from their members to develop legislation that would help ensure Ohio's hospice programs' integrity and quality are maintained, and patients and Ohio tax dollars are protected," White told committee members.

The bill, as amended in committee, includes provisions to:

• Increase hospice license renewals from every three years to annually.
• Establish a six-month moratorium on new hospice licenses, with exceptions for underserved areas.
• Require verified office space and visible signage.
• Strengthen ownership, leadership, and operational accountability requirements.
• Limit administrators and medical directors to serving a single hospice organization, with rural exceptions.
• Require reporting and monitoring of quality and utilization measures, including live discharge rates, length of stay, family satisfaction, transitions of care, service delivery, and aggregate cap utilization.

White also highlighted concerns that nearly half of Ohio hospices currently opt out of certain federal quality reporting requirements, limiting information available to consumers making end-of-life care decisions.

Rep. Bill Roemer (R-Richland Township), the bill's joint sponsor, said the proposal focuses on increased oversight, licensure standards, compliance monitoring, and transparency.

Later Wednesday, House Medicaid Committee members adopted a new substitute version of HB 795, the House's sweeping Medicaid fraud and program integrity proposal. The substitute bill incorporates the hospice integrity provisions from HB 945, ensuring those reforms will continue moving forward as part of the larger Medicaid package.

For members who want to review the language directly, the hospice provisions in the current substitute bill appear primarily on pages 86 through 100. The licensure and ownership changes begin on pages 86 to 91, operational requirements appear on pages 92 to 95, and the leadership and monitoring provisions appear on pages 98 to 100. A comparative synopsis of the previous and substitute versions of HB 795 is available here.

The action comes amid heightened state and federal attention on Medicaid program integrity and follows months of discussion regarding fraud prevention, provider oversight, and accountability across the healthcare system.

This legislation is fast-moving. For more information and updates, visit LeadingAge Ohio’s Hospice Integrity page.