House Committee Seeks Answers from CMS on OIG Hospice Reports

Leaders in the influential Ways and Means Committee in the U.S. House of Representatives have called for stronger supervision of hospice regulatory programs in a letter to Seema Verma, administrator of the U.S. Centers for Medicare & Medicaid Services (CMS).

Committee Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Tex.) signed the letter requesting more details from CMS about the agency’s oversight of hospice providers in the wake of two July reports from the U.S. Department of Health & Human Services Office of the Inspector General (OIG) that cited deficiencies in regulatory compliance, including some that represented serious safety issues.

“We must ensure that the Medicare hospice program is not only reliable but also one that effectively supports both patients and families managing this difficult stage in life,” Neal and Brady wrote in the letter. “Beneficiaries must be equipped with helpful information to make informed choices about their hospice care, and we must identify and root out bad actors that may be putting seniors in harm’s way.”


The first OIG report indicated that about 20% of hospices surveyed by regulators or accreditors between 2012 and 2016 had a condition-level deficiency that posed a serious safety risk. A second report discussed 12 examples of those deficiencies in-depth. OIG examined state agency and accreditor survey findings as well as complaint data from 2012 through 2016. Regulators and accreditors surveyed nearly all hospice providers in the nation during those years.

The reports garnered widespread media attention and elicited strong reactions from hospice organizations. In addition to bringing attention to safety incidents in hospices, the reports called into question the effectiveness of CMS’ enforcement strategies.

Neal and Brady asked Verma to report its progress on meeting OIG recommendations to the committee. The Congress members requested information on how the agency will expand that data it collects on hospice deficiencies and how it ensures those data are reliable, as well as how the agency will strengthen efforts to identify and respond to instances of abuse or neglect.


The OIG report recommended that CMS look into ways to educate hospice providers and staff on identifying abuse or neglect. The committee leaders asked to receive all educational materials that agency intends to provide to hospices on this issue, as well as a plan to disseminate the information. 

Other requests included reports on how CMS interacts with law enforcement in abuse or neglect cases, the process by which patients and families report complaints to the agency, enhanced guidance for CMS surveyors, plans to revamp the agency’s quality reporting processes, and how CMS on the whole intends to strengthen hospice oversight.

Neal and Brady asked Verma to respond within 14 days of receiving the letter.

“Hospice enrollees are some of Medicare’s most vulnerable beneficiaries and deserve the level of care the program has always promised — one that respects the dignity of patients at the end of life and provides the type of individualized plan of care that both patients and their families have the right to expect,” the Congress members wrote.

The House Ways & Means Committee is one of the most powerful in Congress, having jurisdiction over taxation, tariffs, Medicare, Social Security, child support laws and numerous other programs. Committee members are not allowed to belong to any other committees without special permission from congressional leaders.