Protecting Seniors and Stopping Fraudsters Act

Bill Number

H.R. 8883

Origin Chamber

House

Congress

119th Congress, Session 2

Policy Area

Health

Status

Introduced

Latest Action

2026-05-21: Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 27 - 16.

Last Updated

2026-06-03T18:48:14Z

AI-Generated Summary

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

Purpose of the Legislation

This bill amends Title XVIII of the Social Security Act to strengthen Medicare oversight of hospice programs and home health agencies. Its goal is to reduce fraud, improve program integrity, and protect beneficiaries by increasing monitoring, screening, and reporting requirements.

Key Provisions Outlined

• Revalidation of Hospice Enrollments: Requires the Secretary of Health and Human Services to revalidate the enrollment of existing hospice programs in states under enhanced oversight within one year of such oversight beginning.
• Increased Survey Frequency for Hospices and Home Health Agencies: Mandates more frequent surveys (at least every 12 months for 36 months) for newly enrolled providers, those with ownership changes, or reactivated billing privileges. Additional surveys are required within 18 months for providers failing to submit quality data or showing signs of potential fraud, with limits to avoid duplication.
• Stricter Quality Data Requirements: Raises the payment reduction for failing to submit quality data from 4 percentage points (hospices) or 2 percentage points (home health agencies) to 15 percentage points starting in 2029. Allows up to 30 extra days for good-faith submissions.
• Enhanced Enrollment Screening: For high-risk applicants, requires fingerprinting of administrators and medical directors, plus proof of comprehensive liability insurance. High-risk status is determined by rapid growth in provider numbers in a state or county.
• Accreditation Organization Standards: Requires national accreditation bodies to meet or exceed state survey standards, ensure surveyor training, and undergo periodic performance assessments by the Secretary, with possible corrective actions or termination of approval.
• Extension of Hospice Cap Adjustment: Extends the current method for calculating the hospice cap amount through 2036.
• Beneficiary Notices for Hospice Elections: Requires the Secretary to send written notices to beneficiaries within 15 days of electing hospice, including provider details, rights waiver explanation, and revocation instructions. Provides $6 million annually in funding starting in fiscal year 2026.
• Program Integrity Reporting: Mandates annual reports to Congress for five years on audits, reviews, fraud trends, enforcement actions, and efforts to reduce duplication.
• Funding for Implementation: Transfers $100 million from the Federal Hospital Insurance Trust Fund to the Centers for Medicare & Medicaid Services Program Management Account for fiscal year 2026 to support increased surveys.

Significant Changes to Existing Law Introduced

• Adds new revalidation and enhanced screening rules for hospice and home health providers under Section 1866(j).
• Modifies survey requirements in Sections 1822 and 1891 to increase frequency for certain high-risk cases.
• Updates payment adjustment provisions in Sections 1814 and 1895 to raise penalties for non-submission of quality data starting in 2029.
• Introduces performance assessments and remedies for accreditation bodies under Section 1865.
• Extends the hospice cap calculation adjustment in Section 1814(i)(2)(B) by one year.
• Adds a new notice requirement and funding mechanism in Section 1812(d)(2).

Potential Impacts

• On Government Agencies: Increases workload for the Centers for Medicare & Medicaid Services and state survey agencies due to more frequent surveys, screenings, and reporting; additional funding is allocated to support these activities.
• On Citizens: Provides Medicare beneficiaries (particularly seniors) with greater protection against fraud through enhanced oversight and direct notices about hospice elections, potentially improving access to appropriate care.
• On Providers: Hospice programs and home health agencies face stricter enrollment, survey, and compliance requirements, which may raise administrative costs and lead to more enforcement actions such as enrollment revocations.
• On International Relations: No direct impacts identified.

Main Stakeholders Affected

• Hospice programs and home health agencies enrolled in Medicare.
• Medicare beneficiaries, especially those electing hospice care.
• The Department of Health and Human Services and Centers for Medicare & Medicaid Services.
• Accreditation organizations.
• State and local survey agencies.
• Congress, through required reporting.

Notable Legal, Constitutional, or Political Implications

This legislation operates within existing Medicare authority under the Social Security Act, focusing on administrative enhancements rather than new constitutional challenges. It emphasizes fraud prevention and beneficiary safeguards, potentially influencing future program integrity policies without altering core entitlements.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Van Duyne, Beth [R-TX-24]

Recent Actions

• 2026-05-21: Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 27 - 16.
• 2026-05-21: Committee Consideration and Mark-up Session Held
• 2026-05-19: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2026-05-19: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2026-05-19: Introduced in House
• 2026-05-19: Introduced in House

Bill Versions

• Protecting Seniors and Stopping Fraudsters Act — issued 2026-05-19 — PDF (20 pages)