On September 18, Representatives Beth Van Duyne (R-TX), Earl Blumenauer (D-OR), Brad Wenstrup (R-OH), and Jimmy Panetta (D-CA) sent a letter to Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services (CMS), regarding their continued concerns regarding the hospice special focus program (SFP), which is scheduled to launch in November or early December 2024.

The September 18 letter leans into concerns about reputational harm to providers that might be wrongly identified as eligible for the SFP. Citing findings of a recent Government Accountability Office (GAO) report, the authors note that 10% of hospices are still overdue for a survey—and therefore, would not be eligible for SFP. In addition, they note, the report also highlights that a large number of providers do not report CAHPS data and that the current algorithm, with double counting of CAHPS, rewards those non-reporters.

These points are used to underscore the algorithm’s data issues, which could lead to hospice programs either being incorrectly added to the 10% list or put in the SFP itself. This would cause reputational harm and referral sources, the workforce, and beneficiaries may choose another hospice as a result—possibly one that could be of lesser quality. The letter asks for a two-year delay in the public dissemination of the 10% list to prevent this reputational harm.

LeadingAge has, in comment letters over the past two years, expressed concern about the algorithm utilized in the SFP.  This group of Congresspeople had previously expressed concerns about the program in a letter from October 4, 2023, and also asked for a status report on the timeline for the program in May of 2024.