Executive Summary: National Hospice Audit 2023 Survey Report

This morning, NPHI, along with the other national hospice advocacy organizations, released the following statement regarding our ongoing efforts to address program integrity concerns and improve the hospice audit process:

“Following a series of meetings with the Centers for Medicare & Medicaid Services (CMS) and Members of Congress on efforts to improve and protect hospice program integrity, the four preeminent national hospice organizations – LeadingAge, the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO), and the National Partnership for Healthcare and Hospice Innovation (NPHI) – today release findings of a hospice provider survey that underscores the urgency and need for CMS and Congress to act. Previously shared with both CMS and Members of Congress, the survey findings provide policymakers with important on-the-ground examples of shortcomings in the current audit process. Areas of emphasis during these conversations included:

  • The need for hospice audits to appropriately target bad actors and those with deficient quality indicators.
  • A request for CMS to be more transparent regarding the outcomes of the audit adjudication process, including by making denial and appeals data available to providers and the public.
  • Reemphasis on the importance of auditor training to ensure expertise on hospice specific issues, which are distinctly separate from those faced by hospitals or home health agencies.

Throughout 2023, the national hospice trade groups’ advocacy emphasized the need for reforms to ensure program integrity and presented 34 recommendations to CMS. To date, half of these recommendations have been implemented. We look forward to continued work with CMS to improve the audit process to ensure it is equitable and targets genuine instances of fraud, waste, and abuse that negatively impacts well-meaning providers, patients, and the Medicare program.

LeadingAge, NAHC, NHPCO, and NPHI continue to work closely with bipartisan congressional champions to discuss potential legislative solutions including enhanced transparency.”

Read the full release here.