WASHINGTON — The National Hospice and Palliative Care Organization has called on the Centers for Medicare & Medicaid Services to impose a temporary, nationwide moratorium on new hospice provider enrollments, arguing that a flood of fraudulent operators has overwhelmed existing oversight systems and is draining billions from the Medicare program while harming vulnerable patients.
The nation’s largest hospice membership organization sent its request to CMS Administrator Dr. Mehmet Oz, joining a growing coalition of industry groups pressing for federal intervention. The National Partnership for Healthcare and Hospice Innovation also submitted a separate letter to Oz, urging a time-limited pause that would allow CMS to identify and remove fraudulent providers already operating before allowing new entrants into the system.
The Scale of the Problem
The requests come as federal enforcement agencies have documented what they describe as an unprecedented surge in hospice Medicare fraud concentrated in several states. In 2025, CMS referred 343 cases to law enforcement for suspected fraud, representing $3.4 billion in fraudulent billing activity, according to agency data. During the same period, CMS revoked Medicare billing privileges for 4,780 providers and placed 668 hospices under a Provisional Period of Enhanced Oversight.
California has emerged as the fraud epicenter. Eighteen percent of all national Medicare home health and hospice billing originates in Los Angeles County alone, according to CMS figures, while hospice billing activity across the state has grown sevenfold in recent years. A single Los Angeles County physician billed nearly $600 million to Medicare between 2021 and 2024 — nearly $210 million in 2024 alone, a 124 percent increase from 2021 — according to federal investigators.
CMS Administrator Oz has characterized the problem in stark terms. “Money is being sucked out of the system,” Oz said, adding that fraudulent operators had been “calling people who aren’t going to die” to enroll them in hospice without their knowledge or consent. Bill Essayli, First Assistant U.S. Attorney for the Central District of California, said the scale of the fraud was “almost beyond our imagination.”
What Industry Groups Are Asking For
The National Partnership for Healthcare and Hospice Innovation said a nationwide moratorium would serve two purposes: preventing additional questionable providers from entering the system while CMS concentrates resources on removing bad actors already enrolled. The organization asked CMS to define a clear timeline for the moratorium and to preserve telehealth flexibilities for hospice recertifications if a pause is enacted, citing concerns about access to care in rural areas where in-person recertification is difficult.
A coalition that included the California Hospice and Palliative Care Association, the Save Home Health Coalition, and the Texas Association for Home Care and Hospice previously sent a letter to Oz focused on California’s crisis zone. “What began as a serious program integrity problem in isolated markets has evolved into a broader threat to beneficiary protection, Medicare payment integrity, and confidence in the Medicare program itself,” the groups wrote. Sheila Clark, chief executive officer of the California Hospice and Palliative Care Association, said: “Medicare fraud doesn’t just waste taxpayer dollars. It harms patients who rely on benefits and legitimate providers delivering quality care.”
Not all industry voices favor a blanket moratorium. The National Alliance for Care at Home, LeadingAge, and the California Association for Health Services at Home urged CMS to pursue only the “subset of bad actors” and warned that any federal response “must be carefully targeted to protect patients and preserve access to high-quality care” from the majority of providers who serve their communities with integrity.
Background on Hospice Fraud
Fraud hotspots identified by federal watchdogs span six states — California, Arizona, Nevada, Texas, Georgia, and Ohio — where CMS has placed newly enrolling hospices under enhanced oversight citing “serious concerns about market oversaturation.” Common schemes have included enrolling Medicare beneficiaries in hospice without their knowledge, billing for services never delivered, and “license flipping,” in which operators sell newly obtained hospice licenses before regulators can investigate alleged wrongdoing.
California established a multi-agency Hospice Fraud Task Force under Gov. Gavin Newsom and imposed a state moratorium on new hospice licensing. As of March 24, 2026, that moratorium had resulted in more than 280 hospice license revocations, more than 300 providers under active investigation, and 284 criminal arrests, according to the governor’s office.
CMS has existing legal authority under Section 1866(j)(7) of the Social Security Act to impose temporary provider enrollment moratoria in geographic areas with significant fraud risk. In February 2026, CMS exercised similar authority to enact a six-month nationwide moratorium on new Medicare enrollments for certain durable medical equipment suppliers as part of its Comprehensive Regulations to Uncover Suspicious Healthcare initiative. CMS has not publicly responded to the hospice moratorium requests as of March 27, 2026.
Why This Matters for Home Care
Widespread hospice fraud directly harms the patients these services are meant to protect — seniors and seriously ill individuals enrolled without consent, denied appropriate care, or left without legitimate clinical support at the most vulnerable moments of their lives. For families arranging home-based palliative and comfort care, the integrity and accountability of every provider in the care network matters enormously.
For families managing comfort care or end-of-life support at home, the quality of home care equipment can make a meaningful difference when clinical staff access is uncertain. SonderCare’s Aura Premium and Aura Platinum home hospital beds are certified to International Hospital Standard and include Trendelenburg positioning, FallSafe ultra-low height (10-inch platform), and full-electric repositioning — features that support patient comfort and caregiver safety in home-based palliative settings.
If your family is arranging home-based comfort care and needs reliable, hospital-certified equipment, explore SonderCare’s home hospital beds at sondercare.com/beds or speak with a care specialist who can help identify the right configuration for your situation.
Sources: Hospice News (March 20, 2026); Hospice News (January 12, 2026); Governor of California press release (March 24, 2026); CMS enforcement data (2025); StreetInsider.
