Hospice Special Focus Program

The CMS Hospice Special Focus Program (SFP) will monitor hospices identified as poor performers based on selected quality indicators. Hospices selected for the SFP will be under additional oversight to enable continuous improvement. The program, as mandated under the Consolidated Appropriations Act, 2021, amended sections 1822(b), 1865(a), and 1865(b) of the Social Security Act, and would include the development and implementation of enforcement remedies for noncompliant hospice programs, as well as procedures for appealing determinations regarding these remedies. These enforcement actions can be imposed instead of, or in addition to, termination of the hospice program’s participation from the Medicare program. 

In the Calendar Year (CY) 2022 Home Health Prospective Payment System Proposed Rule (86 FR 35874),  CMS proposed a specific methodology and criteria for the program but did not finalize the SFP in the CY 2022 Home Health Prospective Payment System Final Rule (86 FR 62240).  In that Final Rule, CMS also stated their intention to establish a Technical Expert Panel (TEP) to further inform the development of the SFP and reiterated that intention in the Fiscal Year 2023 Hospice Wage Index and Payment Rate Update (87 FR 45669). A link to the TEP report and appendix providing feedback from additional stakeholder listening sessions is in the Downloads section below.

On November 14, 2023, CMS hosted a webinar outlining hospice provisions within the Calendar Year 2024 Home Health Perspective Payment System Final Rule (88 FR 77676). This webinar discussed the finalized Informal Dispute Resolution process, and the Hospice Special Focus Program, including selection criteria, public reporting requirements, enforcement, completion, and termination. A recording of the webinar is available here. A copy of the slides and a transcript are available in the “Downloads” section.

Hospice Special Focus Program List: 

December 20, 2024: Today, the Centers for Medicare & Medicaid Services (CMS) released the list of the initial cohort of 50 hospices selected for participation in the Hospice Special Focus Program (SFP) in 2025. The SFP program, led by the Center for Clinical Standards and Quality, drives hospice quality improvement through increased health and safety oversight. This effort is a continuation of CMS’s commitment to improving hospice care for patients and families by holding hospice agencies accountable to national health and safety standards. 

CMS has also generated a list of future SFP candidates. We are not publishing the candidate list at this time, but we are sharing the underlying data used to create both lists to allow for external review, thereby ensuring transparency in the process by which low-performing hospices are identified. We will continue to work with providers, patients and their families, and industry, to improve hospice care across the nation. The underlying data, the list of the initial cohort of 50 hospices, and the SFP User’s Guide are available in the “Downloads” section. 

The ‘Related Links’ section includes the Hospice Care Compare website, which compares hospices by selected locations, and other related links.