Protecting Seniors and Stopping Fraudsters Act
HB8883, titled the Protecting Seniors and Stopping Fraudsters Act, would expand Medicare oversight of hospice programs and home health agencies. The bill directs the Secretary of Health and Human Services to increase survey frequency for newly enrolled providers, providers with ownership changes, providers that reactivate billing privileges, and providers that fail to submit required quality data or show aberrant patterns that may indicate fraud. It also requires enhanced enrollment screening for providers deemed at extreme risk of fraud, including fingerprinting of key personnel where applicable and proof of comprehensive liability insurance.
The bill also strengthens oversight of Medicare accreditation bodies by requiring survey procedures to meet or exceed state survey standards and by requiring surveyor training before participation on survey teams. It creates a mechanism for periodic performance assessment of accreditation bodies and authorizes remedies if performance is deficient. In addition, the bill extends certain hospice cap adjustments, requires written notice to beneficiaries when hospice elections are made, and mandates annual HHS reporting to Congress on program integrity activities involving hospice and home health providers. The bill includes funding transfers from the Hospital Insurance Trust Fund to support these activities.
The bill would amend multiple provisions of title XVIII of the Social Security Act, primarily affecting Medicare enrollment, survey, quality reporting, and enforcement rules for hospice programs and home health agencies. It would impose more frequent surveys and tougher screening on certain providers, increase financial penalties for failure to submit quality data in future years, require beneficiary notices for hospice election changes, and extend the hospice cap adjustment through 2036. It also authorizes substantial CMS funding for implementation and oversight activities, including $100 million for survey-related enforcement and $6 million annually for election notices.
The available legislative history suggests generally favorable committee sentiment toward the bill’s anti-fraud and oversight goals. The bill was ordered reported by a 27-16 vote, indicating majority support but not unanimity. The title and structure of the bill reflect a strong emphasis on protecting beneficiaries and combating fraud, and the absence of recorded floor debate or transcript excerpts limits evidence of broader public disagreement.
The main points of contention are likely the bill’s increased regulatory burden on hospice programs and home health agencies, especially the more frequent surveys, enhanced screening, and stricter quality-data penalties. Providers may view the new requirements as costly and administratively burdensome, while supporters are likely to argue they are necessary to address fraud, aberrant billing, and weak oversight. Another possible point of debate is the use of Medicare trust fund transfers to finance the new oversight and notice requirements, although the bill frames those expenditures as program-integrity investments.