Efforts to Address Hospice Fraud and Strengthen Program Integrity

Kim Johnson, Secretary of the California Health and Human Services Agency, announced the dismantling of a major hospice fraud scheme that defrauded the state of $267 million at a news conference in Los Angeles on April 9, 2026.

Home healthcare and hospice services are critical to millions of Americans. They rely on these services, trusting that healthcare providers deliver essential care in the home with integrity. Whether it is a home health nurse aiding recovery after hospitalization or a hospice team offering comfort at the end of life, these services play a crucial role in patient and family care.

Fraud within Medicare home health and hospice programs significantly damages this trust. It does not only divert taxpayer dollars but harms individuals, exploits vulnerable people, undermines legitimate providers, and erodes confidence in vital healthcare services.

Tackling healthcare fraud, waste, and abuse is a national priority. Collaborating with the National Alliance for Care at Home, the Protecting Seniors and Stopping Fraudsters Act aims to enhance the integrity of home health and hospice programs. The goal is to protect patient access and reduce burdens on legitimate providers.

For years, signs of hospice fraud were evident. Legitimate providers, families, and policymakers expressed concerns about oversight gaps that allowed exploitation of vulnerable patients and taxpayer money. These issues were addressed to federal regulators during Ways and Means Committee hearings before the media highlighted them.

While fraud gained attention, it is important to note that most hospice providers offer compassionate, high-quality care. This legislation targets fraudulent activities while preserving care access for seniors and families. It provides the Centers for Medicare and Medicaid Services with practical tools to strengthen oversight and accountability.

The measures include penalizing providers failing to submit necessary quality data and requiring site visits for those with suspicious billing patterns. This ensures trust in care within patients’ homes. Strengthening the role and accountability of accrediting organizations prevents fraudulent operators from accessing Medicare.

Preventing bad actors from entering the system is as crucial as removing identified ones. The leadership of Dr. Mehmet Oz in advancing oversight strategies for Medicare and Medicaid is commendable. The focus is on enforcement where needed most.

The objective is shared among providers, regulators, and lawmakers: ensure patients receive safe, high-quality care from trustworthy providers while safeguarding taxpayer resources. This legislation is a step toward achieving that goal, and bipartisan support from Congress is encouraged to protect oversight and patient trust.

Program integrity and patient access are intertwined priorities. Protecting Medicare’s integrity is vital for securing access for dependent patients and families.

Representative Beth Van Duyne, representing Texas’s 24th District, is a member of the House Ways and Means Committee. Jennifer Sheets is the CEO of the National Alliance for Care at Home.