Protecting Seniors and Stopping Fraudsters Act - Amendment in the Nature of a Substitute - H.R. 8883

Sep 7, 2026

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Amendment in the nature of a substitute to H.R. 8883 establishes new hospice oversight requirements in certain states and updates Medicare hospice compliance rules. It revalidates enrollment for hospice programs in specified states unless the programs were already subject to revalidation during the prior 18-month period. It also increases survey frequency for newly enrolled, ownership-changing, reactivated, or qualifying high-risk hospice programs, limits duplicative surveys, and adjusts payment outcomes when required quality data is not submitted.

LanguageEnglish

CategoryHealthcare

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Pages19

Reading Time48 min

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SEC. 1. SHORT TITLE

SEC. 2. REVALIDATING ENROLLMENT OF HOSPICE PROGRAMS IN CERTAIN STATES

SEC. 3. ADDITIONAL OVERSIGHT PROVISIONS FOR HOSPICE PROGRAMS

G:\P\19\H\CMS\MEDCR\WMR\HOSPICE-HHA-AINS_01.XML AMENDMENT IN THE NATURE OF A SUBSTITUTE TO H.R. 8883 OFFERED BY MR. SMITH OF MISSOURI Strike all after the enacting clause and insert the following: 1 SECTION 1. SHORT TITLE. 2 This Act may be cited as the ‘‘Protecting Seniors and 3 Stopping Fraudsters Act’’. 4 SEC. 2. REVALIDATING ENROLLMENT OF HOSPICE PRO- 5 GRAMS IN CERTAIN STATES. 6 (a) IN GENERAL.—Section 1866(j) of the Social Se- 7 curity Act (42 U. S.C. 1395cc(j)) is amended by adding 8 at the end the following new paragraph: 9 ‘‘(10) REVALIDATION OF HOSPICE PROGRAMS 10 IN CERTAIN STATES.— 11 ‘‘(A) IN GENERAL.—In the case that the 12 Secretary provides, pursuant to paragraph 13 (3)(A), that new hospice programs located in a 14 State are subject to the enhanced oversight de- 15 scribed in such paragraph under the program 16 under this title, the Secretary shall, not later 17 than 1 year after the date specified in subpara- 18 graph (B) with respect to such enhanced over g:\V\G\051926\G051926.050.xml (1064641|2) May 19, 2026 (4:41 p.m.) G:\P\19\H\CMS\MEDCR\WMR\HOSPICE-HHA-AINS_01.XML 2 1 sight requirement, revalidate the enrollment in 2 the program under this title of each hospice 3 program located in such State that— 4 ‘‘(i) is not a new hospice program; 5 and 6 ‘‘(ii) was not subject to such revalida- 7 tion during the 18-month period preceding 8 such date. 9 ‘‘(B) DATE SPECIFIED.—For purposes of 10 subparagraph (A), the date specified in this 11 subparagraph is, with respect to an enhanced 12 oversight requirement described in subpara- 13 graph (A)— 14 ‘‘(i) in the case that such requirement 15 took effect before the date of enactment of 16 this paragraph and is in effect on such 17 date of enactment, such date of enactment; 18 and 19 ‘‘(ii) in the case that such require- 20 ment takes effect on or after the date of 21 enactment of this paragraph, such effective 22 date.’’. 23 (b) TECHNICAL CORRECTION.—Section 24 1866(j)(3)(A) of the Social Security Act (42 U. S.C. g:\V\G\051926\G051926.050.xml (1064641|2) May 19, 2026 (4:41 p.m.) G:\P\19\H\CMS\MEDCR\WMR\HOSPICE-HHA-AINS_01.XML 3 1 1395cc(j)(3)(A)) is amended by striking ‘‘title XIX. and’’ 2 and inserting ‘‘title XIX, and’’. 3 SEC. 3. ADDITIONAL OVERSIGHT PROVISIONS FOR HOS- 4 PICE PROGRAMS. 5 (a) INCREASED SURVEY FREQUENCY FOR CERTAIN 6 HOSPICE PROGRAMS.—Section 1822(a)(1) of the Social 7 Security Act (42 U. S.C. 1395i–6(a)(1)) is amended— 8 (1) by striking ‘‘Any entity’’ and inserting: 9 ‘‘(A) IN GENERAL.—Subject to subpara- 10 graph (B), any entity’’; and 11 (2) by adding at the end the following new sub- 12 paragraph: 13 ‘‘(B) INCREASED FREQUENCY FOR CER- 14 TAIN HOSPICE PROGRAMS.— 15 ‘‘(i) NEWLY ENROLLED; CHANGE OF 16 OWNERSHIP; REACTIVATED BILLING PRIVI- 17 LEGES.—Beginning 1 year after the date 18 of enactment of this clause, a hospice pro- 19 gram that is newly enrolled under this 20 title, has undergone a change of ownership 21 (as defined by the Secretary), or has reac- 22 tivated billing privileges under this title in 23 accordance with section 424. 540(b) of title 24 42, Code of Federal Regulations (or a suc- 25 cessor regulation), shall be subject to such g:\V\G\051926\G051926.050.xml (1064641|2) May 19, 2026 (4:41 p.m.) G:\P\19\H\CMS\MEDCR\WMR\HOSPICE-HHA-AINS_01.XML 4 1 a survey not less frequently than once 2 every 12 months during the 36-month pe- 3 riod immediately following such enroll- 4 ment, change, or reactivation. 5 ‘‘(ii) ADDITIONAL HOSPICE PRO- 6 GRAMS.— 7 ‘‘(I) IN GENERAL.—Subject to 8 subclause (II), beginning 1 year after 9 the date of enactment of this clause— 10 ‘‘(aa) a hospice program 11 that did not submit quality data 12 to the Secretary in accordance 13 with section 1814(i)(5)(C) for the 14 most recent fiscal year for which 15 data is available (as determined 16 by the Secretar

FAQs

What is the short title of the act described in the document?

The act is cited as the "Protecting Seniors and Stopping Fraudsters Act."

How does the act address revalidation of hospice enrollment in certain states?

It requires the Secretary to revalidate enrollment for hospice programs located in specified states that are not new and were not subject to revalidation during the prior 18-month period, with a specified effective date depending on when the enhanced oversight requirement took effect.

What changes does the act make to hospice survey frequency and oversight?

It increases survey frequency for certain hospice programs, including newly enrolled, ownership-changing, and reactivated programs, and for programs that fail to submit quality data or show aberrant or potentially fraudulent behavior, while limiting duplicative surveys to no more than one within any 18-month period.

Sep 7, 2026

Upload by Riley