Rep. Beth Van Duyne, (R-Texas) has emerged as one of Washington’s most vocal advocates for hospice providers in Congress.

Elected to the U.S. House of Representatives in 2020, Van Duyne is a member of the influential Ways and Means Committee, overseeing Medicare, Social Security and tax policies among other programs.

Van Duyne was among a group of lawmakers that wrote to the U.S. Centers for Medicare & Medicaid Services’ (CMS) Administrator Chiquita Brooks LaSure last month requesting updates on the agency’s battles against fraudulent providers, as well as a U.S. Government Accountability Office (GAO) report on quality issues in the hospice space.

Hospice News spoke with Rep. Van Duyne in Washington D.C. on congressional efforts to root out fraud and where they should go next.

Given all the matters that come before Congress, what has made you so passionate about the hospice and palliative care space?

We’ve heard from folks who it’s affecting directly, and it’s hard to think of a more vulnerable time in your life. And it’s not just the patients, but it’s their family.

It seems like it should be an easy fix. You see fraud. You see abuse, and you see the people who are being abused. It’s our job in the government to take care of those most vulnerable.

It’s a really hard thing to look at these patients who are at the end of life who deserve to have that kind of respectful care, and are getting bought and sold by fraudulent providers who don’t seem to care at all about anything other than money. And I think that makes it a priority.

What are some of the fixes you would like to see happen?

We had [U.S. Health and Human Services Secretary Xavier Becerra] before the Ways and Means committee a few weeks ago. You look at the hospices that are committing fraud in just unmentionable numbers, we need to crack down on the bad actors who are making the good actors look bad.

They’re also preventing the proliferation of more providers, because we are being very hesitant now to increase their numbers without being able to know who’s committing fraud and who’s not. So I think one of the changes that we need is how we go after those people who are committing fraud.

And when we had Becerra in front of our committee, I showed a picture of this one little building that has 100 different hospice providers. Explain how this is being allowed to happen? How in your audits are you going after the good guys and making them have to go through all the steps, but you’re not identifying these folks?

So I think coming down on those businesses that are looking at this is just a way to make money, and buying and selling patients needs to be a priority, because we want to make sure that the good actors are able to grow. Because there’s definitely an increasing need every day for the hospice services; we don’t want to limit the growth of good actors, but you definitely don’t want to give more money to the bad.

It seems like at least from the outside looking in that there’s a good deal of bipartisan cooperation when it comes to hospice and palliative care issues. Do you see this as an area of common ground between the parties?

When you start breaking down health care in general, there’s a lot more bipartisan work. These are not partisan issues.

I think if we look at the overall regulations that are burdening our health care service providers, we should be on the same page on that. It’s unnecessary. It does nothing to increase care or access, and does everything to increase costs. I would hope that would be a bipartisan focus that we could all agree on. Sometimes the ends are agreed on, but the means to get there are not. But those are being discussed and negotiated.

What are some of your further priorities when it comes to hospice and palliative care?

Making sure that those services are able to be provided to those people who need it, and making sure that people who find themselves in those positions have opportunities to be able to use their insurance, their Medicaid or Medicare policies in a way that benefits the family in a respectful manner.

So often when we pass laws, we’ve got folks from [CMS] who are well-meaning, but a lot of times I think they’re over their skis. So the regulatory format doesn’t necessarily reflect the intent of the policies, the laws that we pass. 

Some of the time that we need to spend is looking at the unintended consequences of the laws that we pass and making sure that CMS and others are enforcing regulations that aid in that intent and not in other things that do nothing more than just proliferate the size of an agency.

Do you think there should be perhaps a better mechanism for CMS to refer cases to the Justice Department in cases where there’s evidence of fraud?

They have the ability to do that. Whether or not that needs to be clarified, it’s definitely something that our office can review and look further into.

The FBI is already looking at some of those cases. So that path already exists. But looking at whistleblowers too, I think that is something that we should be exploring. People who have first-hand experience seeing the fraud should have an easy way of being able to report it.