Van Duyne Introduces the Protecting Seniors and Stopping Fraudsters Act to Enact Mandatory Oversight Requirements to Combat Hospice and Home Healthcare Fraud

Washington, D.C. - Since 2023, Rep. Van Duyne (TX-24) has been a recognized leader on the issue of exposing and stopping hospice and home healthcare fraud that steals billions of taxpayer dollars, weakens the Medicare program for American citizens, and harms seniors across the country when they are at their most vulnerable and in need of quality care. As the Trump Administration continues investigations and suspension of licenses of hundreds of fraudulent care providers across the country, Rep. Van Duyne introduced new legislation, the Protecting Seniors and Stopping Fraudsters Act, to strengthen Medicare oversight, crack down on bad actors, protect seniors from fraudulent enrollments, and improve accountability across the hospice and home health system.

"Every single dollar stolen by criminals from Medicare is a dollar ripped away from a vulnerable senior who is just trying to spend their final days in comfort, peace, and dignity. Americans are disgusted by the heartless actions of scammers treating these vital lifelines as personal ATMs and demand reforms to stop these criminals before they can steal precious taxpayer dollars, thereby further weakening the Medicare system," said Rep. Van Duyne. "My bill takes a proactive approach to stop fraud by strengthening oversight of high-risk hospice programs and home health agencies through enhanced enrollment screening, mandating more frequent surveys for new and suspicious providers, establishing stronger accreditation standards, and increasing transparency around enforcement activities. The Center for Medicare & Medicaid Services needs and deserves these measures to fight the continued exploitation of services our seniors rely on."

"The National Alliance for Care at Home (the Alliance) appreciates Rep. Van Duyne for her leadership in advancing targeted, data-driven program integrity solutions for Medicare home health and hospice. The Alliance supports the Protecting Seniors and Stopping Fraudsters Act, which utilizes targeted metrics to eliminate bad actors from the Medicare hospice and home health systems. This legislation has the potential to reduce the burden on legitimate providers, and ensure that bad actors cannot exploit the trust that beneficiaries place in our federal programs.

The Alliance looks forward to continuing to collaborate on these reforms, including seeking a positive resolution to the overly broad national enrollment moratorium on new home health and hospice providers, which poses risks to legitimate providers and patient access. We will continue to work together with lawmakers to preserve and strengthen access to high-quality care in the home for the Americans who depend on it most." - Jennifer Sheets, Chief Executive Officer, National Alliance for Care at Home

Summary and Key Provisions:

This legislation is a targeted Medicare program integrity package focused on cracking down on hospice and home health fraud while protecting legitimate providers and patient access. The bill is designed to move Medicare oversight from a reactive model to a proactive one by identifying bad actors earlier, particularly in geographic hotspots where provider growth far exceeds patient growth. It targets providers with aberrant billing, discharge, enrollment, or low-quality reporting patterns rather than imposing blanket burdens across the industry.

• Increased survey frequency for newly enrolled hospices and home health agencies, providers with ownership changes, or providers displaying signs of fraudulent behavior.

• Enhanced screening requirements for providers deemed at "extreme risk" of fraud, including fingerprinting administrators and medical directors and requiring proof of liability insurance.

• Greater accountability for accrediting organizations through standardized survey training requirements.

• New beneficiary notification requirements to ensure seniors know when they have been enrolled in hospice and understand how to disenroll if fraud or abuse occurs.

• Annual reporting to Congress on CMS program integrity activities, enforcement actions, fraud trends, and efforts to reduce unnecessary administrative burden on legitimate providers.

Click HERE to read the full bill text.

Background:

• In February 2023, a bipartisan group of lawmakers led by Rep. Van Duyne and Rep. Blumenauer sent a letter to the Center for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure expressing their concern about fraud and abuse within the hospice benefit and requesting a briefing on CMS's hospice-related oversight activities as well as any gaps in oversight tools.

• In March 2023 at a Ways and Means Committee hearing, Rep. Van Duyne questioned the then-Secretary for Health and Human Services (HHS), Xavier Becerra, on his agency's failure to conduct proper oversight of the hospice benefit.

• In June 2023, Rep. Van Duyne and a bipartisan group of lawmakers sent a letter to HHS Inspector General Christi Grimm about newly certified hospices that engaged in unlawful, unethical practices, resulting in alarming reports of fraud & abuse that threatened both patient safety and fiscal responsibility.

• In March 2024, Rep. Van Duyne questioned then-HHS Secretary Becerra again on his failure to address fraudulent hospice schemes that defrauded taxpayers out of millions of dollars.

• In May 2024, Rep. Van Duyne and Rep. Blumenauer led a bipartisan group of 38 lawmakers demanding answers from CMS on the implementation of recent reforms aimed at combating hospice fraud and abuse.

• In June 2024, Rep. Van Duyne was recognized with the Hospice Action Network Angel Award from the National Hospice and Palliative Care Organization for her work to combat fraud and abuse in our hospice programs.

• In November 2024, Rep. Van Duyne introduced the Enhancing Hospice Oversight and Transparency Act, bipartisan legislation to restore integrity in the hospice benefit.

• May 2026, CMS announces the suspension of approximately 800 hospice service providers citing massive, suspected Medicare fraud.