Efforts to Combat Hospice Fraud Strengthened with New Legislation

Kim Johnson, Secretary of the California Health and Human Services Agency, announced the dismantling of a significant hospice fraud scheme during a news conference in Los Angeles on April 9, 2026. This scheme defrauded California of $267 million. The announcement underscores the importance of integrity in healthcare services that many Americans rely on, especially in home health and hospice care.

Home care services are vital for millions who depend on the assistance of health professionals for safe recovery and end-of-life care. Providers deliver these essential services by visiting patients at home, which necessitates a high level of trust. Therefore, the presence of fraud in Medicare home health and hospice programs not only causes financial loss but also erodes public confidence and harms vulnerable patients.

Addressing fraud, waste, and abuse in healthcare remains a national priority. To tackle these issues, collaboration with the National Alliance for Care at Home has resulted in new legislation called the Protecting Seniors and Stopping Fraudsters Act. This act focuses on strengthening program integrity in home health and hospice services while ensuring access to care and reducing burdens for legitimate providers.

Despite ongoing concerns about hospice fraud over the years, many providers continue to deliver compassionate, high-quality care. The new legislation takes a targeted and data-driven approach to address fraud without compromising care access for seniors and families. It empowers the Centers for Medicare and Medicaid Services (CMS) with tools to enhance oversight and accountability.

Provisions in the legislation include penalizing providers that do not submit necessary quality data and requiring site visits for those with suspicious billing patterns or other fraud indicators. This initiative aims to support trustworthy care teams that patients can rely on.

Accrediting organizations will also play a more robust role in preventing fraudulent operators from accessing Medicare initially. Stopping fraudsters from entering the system is as crucial as removing them after detection.

The leadership of Dr. Mehmet Oz is recognized for contributing to oversight strategies for Medicare and Medicaid aimed at targeted enforcement. The shared goal among providers, regulators, and lawmakers is to guarantee safe, high-quality care and efficient use of taxpayer resources.

This legislation marks a noteworthy step toward achieving greater oversight, safeguarding patients, and maintaining public trust in home-delivered care. It calls for bipartisan support from Congress to bolster these efforts.

Protecting Medicare’s integrity is vital for ensuring that patients and families who depend on these services continue to have access. Representative Beth Van Duyne of Texas and Jennifer Sheets, CEO of the National Alliance for Care at Home, emphasize this shared responsibility.