A federal court has ordered a stay on litigation intended to block the hospice Special Focus Program (SFP) after the U.S. Centers for Medicare & Medicaid Services (CMS) pledged that it would not resume implementation during 2025.

The crux of a lawsuit filed by hospice organizations against the U.S. Department of Health and Human Services (HHS) is the criteria that the agency uses to select hospices for the new Special Focus Program (SFP).

A group of providers and state associations are plaintiffs in the suit, including Texas Association for Home Care & Hospice, Indiana Association for Home & Hospice Care, Association for Home & Hospice Care of North Carolina, South Carolina Home Care & Hospice Association and Houston Hospice. They have asked the U.S. District Court in the Southern District of Texas-Houston Division for a preliminary injunction that would halt the SFP, according to their complaint.

“We are pleased that CMS has committed not to resume the Special Focus Program (SFP) this year, such that the SFP litigation is paused for now,” Rachel Hammon, executive director of the Texas Association for Home Care & Hospice, said in a statement. “This is an important step forward in our ongoing efforts to work with CMS on developing a SFP that truly serves patients and fulfills Congress’ intent to identify and improve poor-performing hospices.”

The SFP can impose enforcement remedies against hospices with poor performance on regulatory or accreditation surveys. Hospices flagged by the SFP would be surveyed every six months rather than the current three-year cycle. Enforcement actions could include expulsion from the Medicare program, as well as other penalties.

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.

“CMS has willingly tolerated bias in its algorithm, such as skewing toward large providers that serve many beneficiaries per year, but failed to offer a reasoned explanation for doing so, given it prevents CMS from identifying the worst performing hospices for the Special Focus Program,” the organizations indicated in a complaint filed with the court.