The Trump Administration has suspended implementation of the hospice Special Focus Program.
Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. However, stakeholders in the hospice space have contended that the agency’s methodology for selecting hospices for the program is deeply flawed.
Notice of the suspension appeared today on the U.S. Centers for Medicare & Medicaid Services (CMS) website.
“Effective February 14, 2025, implementation of the Hospice Special Focus Program for CY 2025 has ceased so that CMS may further evaluate the program,” the agency indicated.
The SFP was among the requirements established by the Consolidated Appropriations Act of 2021. Congress included the language in response to July 2019 reports on hospice quality from the Office of the Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS). CMS expects that implementation of these proposals would cost an estimated $5.5 million annually.
The SFP had the power to impose enforcement remedies against hospices with poor performance on regulatory or accreditation surveys. Hospices flagged by the SFP were to be surveyed every six months rather than the current three-year cycle.
Providers that had been selected for the program in 2025 received this notice from CMS:
“CMS is exercising its enforcement discretion to cease implementing the Hospice Special Focus Program (Hospice SFP) for CY 2025 and will further explore options for program implementation and further rulemaking,” CMS stated in messages to providers. “If your organization was previously deemed under a CMS-approved Accrediting Organization (AO), and you wish to continue under deemed status and accreditation with your AO, you must contact them to make them aware of your decision. If you choose to withdraw your accreditation, your organization will remain under the State Survey Agency (SA) jurisdiction.”
Stakeholders in the hospice community were quick to praise the action.
“We wholly support the creation of a special focus program, in both spirit and intent, a point we have emphasized repeatedly since the passage of the Hospice ACT of 2020, which authorized the SFP’s creation,” Katie Smith-Sloan, president and CEO of LeadingAge said in a statement emailed to Hospice News. “We said that we support the SFP in spirit and intent; for an SFP to succeed, good execution is critical and on this, CMS failed miserably, so the decision to cease implementation is a win for providers and for all Americans seeking quality hospice care.”
Some regarded the suspension as the positive outcome of advocacy work by state and national industry groups.
“This outcome reflects the dedicated advocacy efforts of the hospice community, including a multi-state coalition of hospices and hospice associations that came together to challenge the deeply flawed SFP. We look forward to working with the new administration and CMS to ensure fair and effective oversight,” said Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation.
The National Alliance for Care at Home applauded the suspension and cited a recent lawsuit filed by a group of hospices and state associations that challenged the SFP.
“The National Alliance for Care at Home welcomes this decision as a positive move, acknowledging that the current approach was not working as intended,” the Alliance indicated in a statement. “This announcement comes following the filing of a legal action from a multi-state coalition of hospices and hospice associations to challenge a program that misrepresented hospice compliance records, misused data, and jeopardized access to high-quality end-of-life care. “
