[WASHINGTON, DC] — The National Partnership for Healthcare and Hospice Innovation (NPHI) supports the continued focus by Congress and the Administration on addressing fraud, waste, and abuse within the Medicare hospice benefit.
NPHI’s policy team, led by Ethan McChesney and joined by Quin Lyons, attended the House Ways & Means Full Committee hearing titled “Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud,” on April 21, reinforcing NPHI’s active engagement on this issue.
Recent oversight activity reflects a growing recognition of a serious program integrity problem impacting the Medicare hospice benefit. It is significant, and it is undermining trust in a benefit that millions of patients and families rely on during some of the most vulnerable moments of their lives.
NPHI’s nonprofit hospice members have long been on the front lines of identifying and calling attention to these bad actors. These organizations are deeply rooted in their communities, providing high-quality, mission-driven care and upholding the integrity of the Medicare hospice benefit as it was intended.
“Fraud in hospice is not a theoretical concern – it is happening in real time, and patients and families are paying the price,” said Tom Koutsoumpas, Founder and CEO of NPHI. “We are seeing entire markets impacted by actors who have no connection to the communities they claim to serve. These fraudulent actors must be rooted out of the system — at once. Addressing this requires urgency, precision, and a commitment to protecting both beneficiaries and the providers who are delivering care the right way.”
NPHI has been actively engaged with federal leaders on solutions and has called for decisive, targeted action to stop the growth of fraudulent activity. At the end of March, NPHI submitted a letter directly to CMS Administrator Dr. Mehmet Oz and Deputy Administrator and COO Kim Brandt urging the implementation of a temporary nationwide moratorium on new hospice provider enrolments. This action is essential to prevent additional bad actors from entering the program while enabling CMS to fully focus its resources on identifying and removing those already operating within it.
NPHI also responded to the Administration’s Request for Information on Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) on March 30, 2026, reinforcing the need for coordinated, data-driven oversight by providing a series of recommendations aimed at cracking down on fraudulent activity.
Recent enforcement actions, including arrests and the shutdown of fraudulent hospice operations in the Los Angeles area, underscore both the scale and urgency of the issue. These developments highlight the need for sustained, targeted intervention in regions experiencing a high concentration of suspicious activity.
NPHI continues to work closely with the Administration and CMS to advance policies that:
- Stop the entry of new fraudulent providers into the program
- Identify and remove existing bad actors more quickly
- Protect access to care for patients and families
- Reduce unnecessary burden on high-quality, compliant providers
Hospice care, when delivered as intended, is one of the most compassionate and effective models in healthcare. Preserving that promise requires decisive action. NPHI remains committed to partnering with policymakers to ensure the Medicare hospice benefit is protected, and worthy of the trust patients and families place in it every day.
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