Lawmakers to weigh moratorium on new hospice providers amid ‘unusually high live discharge rates among some providers’

Proposed legislation would institute a six-month moratorium on approving new hospice providers or on allowing ownership changes for current providers.

House Bill 945, which had its first hearing on Wednesday before the House Health Committee, would also increase the frequency of hospice license renewal from every three years to annually.

“Ohio has experienced a rapid surge of growth in the number of hospices in the last 3 years,” state Rep. Andrea White, R-Kettering, said in prepared sponsor testimony. “Currently there are 184 licensed hospices in our state, with one in four opening in the last five years. That’s a 16.5% increase.”

White, who sponsored the measure with state Rep. Bill Roemer, R-Richfield, noted that in December 2025, the Centers for Medicare and Medicaid Services added Ohio and six other states to its Enhanced Oversight Program.

“This designation intensifies the monitoring of the state’s hospices,” White said. “CMS has not publicly disclosed specific reasons for Ohio’s inclusion. We can only speculate.”

Allegations of widespread fraud in the state have swirled in recent months, mostly centering on Medicaid and Supplemental Nutrition Assistance Program benefits. Lawmakers seem to be stepping up proposals to counter fraud in response to the negative headlines.

White cited a LeadingAge finding that a review of hospice licenses issued since 2021 reveals that most new hospices are opening in Ohio’s largest metropolitan markets, where there is already a concentration of hospice providers, rather than in underserved rural communities.

“This saturation combined with warning signs such as unusually high live discharge rates among some providers, lead us to recommend tightening up the ways we have been approving hospice licenses and overseeing existing providers,” White said. “There are considerable opportunities to amend Ohio’s hospice licensure and accountability practices to prevent substandard operators from practicing in the state, while increasing transparency and disclosure for existing programs to prevent fraud and protect patients and families. And HB 945 is a roadmap to do just that.”

Nationally, allegations of fraud within hospice have generally centered on California.

“The Southern California region is a high-risk environment for hospice-related and many other forms of health care fraud,” Akil Davis, the assistant director in charge of the FBI’s Los Angeles Field Office, said in an April release about the arrest of eight on charges that include running “sham hospice care facilities” that defraud Medicare. “The United States loses hundreds of billions of dollars annually to healthcare fraud at the expense of all American taxpayers, whose benefits decrease as premiums, co-payments and taxes grow.”

Separately, the Ohio Department of Behavioral Health has implemented a temporary freeze and enhanced review process for proposed behavioral health and rehab providers.

“After years of fraud concerns, patient brokering, Medicaid abuse, and questionable out-of-state operators flooding communities, Ohio is finally cracking down,” state Rep. Justin Pizzulli, R-Scioto County, said in a release. “Addiction recovery should be about helping people, not exploiting them for money.”