H.R. 8883: Protecting Seniors and Stopping Fraudsters Act

This bill, known as the Protecting Seniors and Stopping Fraudsters Act, aims to enhance oversight of hospice programs and home health agencies under the Medicare program. Below are the key provisions of the bill:

1. Revalidation of Hospice Programs

- The Secretary of Health and Human Services is required to revalidate the enrollment of existing hospice programs in certain states that are under enhanced oversight approximately one year after the enactment of this bill.

2. Increased Oversight for Hospice Programs

- The frequency of surveys for newly enrolled hospice programs, those that have undergone a change of ownership, or those that have reactivated billing privileges will increase to at least once a year during the first 36 months after these changes.- Additional surveys will be conducted if certain quality metrics are not met or if the discharge rates are deemed aberrant.

3. Payment Adjustments for Quality Data

- If hospice programs fail to submit quality data to the Secretary of Health and Human Services as required, there will be payment adjustments for the years 2024 through 2028. For 2029 and beyond, the penalties will increase.

4. Increased Oversight for Home Health Agencies

- Similar to hospice programs, home health agencies will also face increased survey frequencies under the same conditions, with annual reviews for the first three years after changes.

5. Enhanced Enrollment Screening

- The bill proposes more stringent enrollment screening for hospice programs and home health agencies, particularly those identified as high risk for fraud. This may include fingerprinting of key personnel and proof of liability insurance.

6. Additional Requirements for Accreditation Organizations

- There will be new requirements for accreditation organizations that assess hospice programs and home health agencies, ensuring higher standards for survey procedures and training.

7. Adjustments to Hospice Cap Calculation

- The bill modifies the calculation of the hospice cap amount under Medicare, extending certain adjustments until 2036.

8. Notices Regarding Revocation of Hospice Elections

- The bill mandates that individuals who elect hospice care be notified within 15 days of their election, including important contact information and details about their rights.

9. Reporting on Program Integrity Activities

- An annual report will be required from the Secretary of Health and Human Services on the outcomes of program integrity activities focusing on hospice programs and home health agencies.

10. Funding Provisions

- The bill allocates specific funding from the Federal Hospital Insurance Trust Fund to support the oversight and integrity activities described in the bill.

Relevant Companies

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