Hospice & Home Health News 2026June26

Kierstin Reed • June 25, 2026

OIG Report Cites Concerns with Hospice Enrollment Eligibility Costing Medicare $255.1 Million

A report released by the Office of Inspector General (OIG) on June 23 found that Medicare could have saved $255.1 million if Medicare Administrative Contractors (MACs) had stricter eligibility review procedures. The report looked at 100 initial certification period documentation from 2021 for new hospice enrollees who did not have inpatient or emergency room (ER) claims 18 months prior to starting hospice care. Additionally, these sampled enrollees had at least one paid hospice claim in FY2021 and were still alive 180 days after starting hospice care. OIG found that of the 100 certification periods reviewed, 45 did not meet hospice eligibility requirements. First, clinical documentation for 21 did not support the enrollee's 6-month prognosis. Second, of the 100 periods reviewed 24 did not meet eligibility documentation requirements due to missing supporting documentation, missing elements on the election statement, missing certification of terminal illness, missing information on the certification of terminal illness, and missing signatures from physicians or enrollees. Based on this review, OIG determined that the Centers for Medicare and Medicaid Services (CMS) overpaid these claims by $545,499 and extrapolated that estimate across all hospice claims for these patients in FY2021 to total $255.1 million. In the report, OIG recommended that CMS work with the hospice MACs to consider hospice enrollees with no hospital or ER visits 18 months prior to hospice as a high-risk area in their hospice eligibility reviews. They also recommend MACs "possibly develop pre- or postpayment review procedures" for these new hospice enrollees. CMS concurred with OIG's recommendation and will share the report with MACs to incorporate into their risk analysis and work planning to determine whether the risk area identified in this audit report should be prioritized. LeadingAge will work to follow up with members on the outcomes of this report in terms of MAC audits. Hospice members should consider reviewing their own enrollees and determining the potential risk of compliance issues for individuals with no hospitalizations or ER visits in the preceding 18 months before enrollment and were still on hospice service after 180 days.

GAO Argues Hospices Be Paid Per Visit

A new report from the Government Accountability Office (GAO) finds 20% of hospices were paid more for care than other hospices due to lower visits rates. The report also estimates potential savings in a per-visit payment rates for hospice routine home care. Read LeadingAge's full analysis of the report here.

455 Defendants Identified in National Health Care Fraud Takedown

The Office of Inspector General (OIG) joined federal and state law enforcement announced charges against 455 defendants, including 90 doctors and other medical professionals, for health care fraud and opioid abuse schemes. Defendants included individuals connected with fraudulent claims for amniotic wound allografts driven by a kickback scheme for marketers and medical providers. The alleged kickbacks caused the targeting of hospice patients and applying the allografts "without coordination with the patients’ treating physicians." In other cases, the skin allografts where never even applied. LeadingAge made clear in our comments on the FY2027 Hospice Proposed Rule that any Part B spending on skin allografts (which made up more than 50% of all Part B non-hospice spending) should be removed from the Services and Spending Variation Index non-hospice spending measure due to the overwhelming evidence of fraudulent billing. Additionally, a hospice owner and employees were charged in a scheme that attempted to avoid detection by purchasing information from funeral home employees and fraudulently enrolling deceased Medicare beneficiaries. The owner allegedly billed Medicare for a few days of hospice services for these recently-deceased individuals who had not received hospice care and created fake, back-dated medical records claiming that the beneficiaries had been seen by a physician, thereby allegedly seeking to deceive Medicare by reducing his outlier data metrics on live-discharges. This specific case illustrates another point LeadingAge made in our comments on FY2027 Hospice Proposed Rule, that relying on one metric for fraud detection, such as live-discharge rates, and suspending payments based on that factor is not an effective enforcement tactic and could catch well-meaning providers while missing fraudulent actors.

Here is your weekly  Home Health Weekly Recap from National.

Here is your weekly  Hospice Weekly Recap from National.

By Kierstin Reed • September 24, 2026
HUD Report Highlights BABA Implementation, Monitoring Issues. On September 10, the Department of Housing and Urban Development (HUD) published a report by its own oversight entity, the Office of the Inspector General (OIG), evaluating the agency’s implementation of Build America, Buy America (BABA) requirements throughout HUD programs. The Buy America Preference within BABA requires federal agencies to limit federal infrastructure spending unless the iron, steel, manufactured, and construction products used were domestically sourced in the U.S., which has proven infeasible for LeadingAge members developing new affordable housing units. The report, titled “HUD Needs to Improve its Monitoring of the Buy America Preference of the Build America, Buy America Act,” called out HUD’s lack of compliance monitoring for BABA; OIG recommends that HUD designate an official responsible for overseeing BABA implementation and consistency across HUD program offices. BABA is applicable to four HUD program offices, including the Office of Multifamily Housing Programs, which administers the Section 202 Supportive Housing for the Elderly program, as well as the Green and Resilient Retrofit Program (GRRP), both of which are subject to BABA requirements. LeadingAge continues to urge HUD and Congress to fully exempt affordable housing developments from the Buy America requirements because they are too difficult to execute and the original statute did not intend to BABA requirements to affordable housing. HUD Publishes LeadingAge-Driven Flexibilities on Emergency Call Systems. On September 10, the Department of Housing and Urban Development (HUD) published new guidance, driven by concerns shared by LeadingAge, to create more flexibility within emergency notifications system requirements for affordable senior housing providers. Previously, the agency required owners of certain HUD-assisted senior housing communities to operate emergency call systems in independent living units, which could be used by residents to call for aid in the case of an emergency, like a fall or a medical event. However, LeadingAge members consistently reported issues with the call systems, including residents misusing the systems and property insurance providers limiting whole-building coverage because of the perceived liability risk associated with the medical nature of the emergency notification devices and systems. Further, many residents reported to housing providers that they prefer to utilize personally-worn emergency devices and view the property call system as overreach by housing providers. In its new guidance, HUD makes the systems optional and encourages owners to conduct wellness checks instead, which many LeadingAge affordable housing providers already do. LeadingAge confirmed with HUD that the removal of the now optional emergency notification systems is a project-eligible expense. We applaud HUD for addressing the concerns of senior housing communities, and we will work with our membership to ensure the highest quality of housing for HUD-assisted residents. Here is your weekly Affordable Housing Weekly Recap.
By Kierstin Reed • September 24, 2026
CMS' Technical Error in Final FY27 Hospice Wage Index
By Kierstin Reed • September 24, 2026
LeadingAge Nebraska Testifies at LR481
By Kierstin Reed • September 24, 2026
Coalition Partners to Host Webinar on El Salvador TPS. As many LeadingAge members know firsthand, the future of Temporary Protected Status (TPS) is creating significant uncertainty for employees, employers, and communities across the country. Two LeadingAge coalition partners – WorkPermits.US and the American Business Immigration Coalition (ABIC) – will host a virtual webinar on Thursday, September 17 at 3p ET that will provide U.S. employers with critical updates regarding the status of work authorization for Salvadoran employees with TPS. As of September 9th, El Salvador TPS is still in place , pending the government's decision on whether to extend the program. Nonetheless, for employers, changes to TPS can have real consequences for workforce stability, employee retention, recruitment, and business operations. It is important for employers to understand what these changes mean, what responsibilities they have, and how they can support their employees with TPS. During the virtual webinar, expert panelists will cover compliance responsibilities, employer legal obligations, and actionable advocacy steps to protect essential workers. Register here if interested in this topic, and as always, reach out to Associate Director for Immigration Advancement Shane Myers if you have questions or concerns. Here is your weekly Workforce Weekly Recap
By Kierstin Reed • September 24, 2026
CDC Releases Updated Return-to-Work Guidance
By Kierstin Reed • September 24, 2026
LeadingAge Assisted Living Study Underway Participation is officially open for the 2026-2027 Assisted Living Salary & Benefits Study . Now in its 29th consecutive year, the national survey is conducted by HCS in cooperation with LeadingAge . Below is a brief overview on the study: Submission Deadline : November 9th Report Publication : January 2027 LeadingAge Participant Pricing: $190 (pre-paid) / $210 (billed) vs. $400 non-participant rate Questionnaire Download : www.hhcsinc.com Below is a full press release with survey links to share with members. Kindly confirm receipt. Thank you! 2026 HCS Assisted Living Salary & Benefits Study Underway Hospital & Healthcare Compensation Service (HCS) is conducting its annual Assisted Living Salary & Benefits Study and requests your participation. Assisted Living/Personal Care/Residential Care providers are invited to complete and submit the study questionnaire by November 9th. The national study is published by HCS in cooperation with LeadingAge . There is no cost to participate. Survey respondents receive a substantial discount, with options to purchase the final results for $190 (pre-paid) or $210 (billed), compared to the $400 non-participant rate. Questionnaires are available for download on the HCS website at: www.hhcsinc.com . The results will be published in January 2027. Last year’s Report contained data from 1,057 communities nationwide. The results cover salaries, bonuses, and hourly rates for 50 positions, with data reported regionally by bed-size, profit type, and revenue, as well as by state and CBSA. The report also covers 18 fringe benefits, including health/dental/vision insurance, PTO/time-off policies, 401(k) plans, and educational assistance, while also covering critical metrics like turnover rates, granted/budgeted salary increases, shift differentials, and sign-on bonuses. If you should have any questions, or find you need additional time beyond 11/9 to submit your data, please contact Rich Cioffe at rjcioffe@hhcsinc.com , (201) 405-0075, ext. 10. HCS publishes ten annual compensation studies. Nationally known, their reports are recognized as the standard for reliable, comprehensive, and affordable compensation data for healthcare. Thank you for your continued support! Here is your Life Plan Community Weekly Recap .
By Kierstin Reed • September 24, 2026
Bipartisan Bill Seeks to Stop Medicare Advantage Payment Clawbacks Reps. Greg Landsman (D-OH) and Bob Onder (R-MO) introduced the bipartisan Protecting Approved Care Act, legislation aimed at preventing Medicare Advantage (MA) plans from retroactively denying or reducing payment for care that has already been approved and delivered. The bill would apply protections to prior authorizations, pre-service and concurrent determinations, and authorizations for transfers from hospitals to post-acute care settings. LeadingAge appreciates the bill’s focus on practices our nonprofit and mission-driven members increasingly encounter, including plans denying or making only partial payment for previously approved services and seeking lower payments than CMS-required assessments indicate. Providers should be able to rely on an MA plan’s approval when they furnish care in good faith rather than face burdensome appeals or legal action after services have already been delivered. LeadingAge is reviewing the legislation and its implications for members and will continue engaging with Congress on policies that ensure MA plans appropriately cover and pay for needed care. Here is the link to the recording of last week’s Joint Provider-Surveyor Training: https://vimeo.com/1226926568/a6ed3394ec?fl=tl&fe=ec&share=copy LeadingAge Nebraska Testifies at LR481 Senator Bostar held a hearing on Wednesday this week regarding LR481 with a purpose of examining the fiscal and operational issues related to the addition of long-term care services and supports to the Medicaid managed care program. LeadingAge Nebraska provided testimony that would caution the state against this implementation and would encourage them to proceed with thoughtful planning and collaboration prior to implementation. In his closing comments, Senator Bostar asked an important question, “Is it necessary?” He pointed out that the state has held off on implementing this for the long term care sector for a reason. Nebraska should examine the reason they want to implement this and the complications that could result from the implementation. LeadingAge Nebraska and our members continue to meet with MCO’s regarding this on a quarterly basis and we encourage members to participate in those meetings.
By Kierstin Reed • September 24, 2026
 FRIENDS OF LEADINGAGE NEBRASKA PAC - We need your support!
By Kierstin Reed • September 17, 2026
HUD Report Highlights BABA Implementation, Monitoring Issues. On September 10, the Department of Housing and Urban Development (HUD) published a report by its own oversight entity, the Office of the Inspector General (OIG), evaluating the agency’s implementation of Build America, Buy America (BABA) requirements throughout HUD programs. The Buy America Preference within BABA requires federal agencies to limit federal infrastructure spending unless the iron, steel, manufactured, and construction products used were domestically sourced in the U.S., which has proven infeasible for LeadingAge members developing new affordable housing units. The report, titled “HUD Needs to Improve its Monitoring of the Buy America Preference of the Build America, Buy America Act,” called out HUD’s lack of compliance monitoring for BABA; OIG recommends that HUD designate an official responsible for overseeing BABA implementation and consistency across HUD program offices. BABA is applicable to four HUD program offices, including the Office of Multifamily Housing Programs, which administers the Section 202 Supportive Housing for the Elderly program, as well as the Green and Resilient Retrofit Program (GRRP), both of which are subject to BABA requirements. LeadingAge continues to urge HUD and Congress to fully exempt affordable housing developments from the Buy America requirements because they are too difficult to execute and the original statute did not intend to BABA requirements to affordable housing. HUD Publishes LeadingAge-Driven Flexibilities on Emergency Call Systems. On September 10, the Department of Housing and Urban Development (HUD) published new guidance, driven by concerns shared by LeadingAge, to create more flexibility within emergency notifications system requirements for affordable senior housing providers. Previously, the agency required owners of certain HUD-assisted senior housing communities to operate emergency call systems in independent living units, which could be used by residents to call for aid in the case of an emergency, like a fall or a medical event. However, LeadingAge members consistently reported issues with the call systems, including residents misusing the systems and property insurance providers limiting whole-building coverage because of the perceived liability risk associated with the medical nature of the emergency notification devices and systems. Further, many residents reported to housing providers that they prefer to utilize personally-worn emergency devices and view the property call system as overreach by housing providers. In its new guidance, HUD makes the systems optional and encourages owners to conduct wellness checks instead, which many LeadingAge affordable housing providers already do. LeadingAge confirmed with HUD that the removal of the now optional emergency notification systems is a project-eligible expense. We applaud HUD for addressing the concerns of senior housing communities, and we will work with our membership to ensure the highest quality of housing for HUD-assisted residents. Here is your weekly Affordable Housing Weekly Recap.
By Kierstin Reed • September 17, 2026
CMS' Technical Error in Final FY27 Hospice Wage Index
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