New Certification Aims to Curb Epidemic of Hospice Fraud

NEW YORK CITY, NY – February 03, 2026 – In a direct response to a growing crisis of fraud and abuse within the hospice industry, Empassion Health, Inc. today launched Empassion Assured, a first-of-its-kind independent certification program for hospice providers. The initiative aims to create a new benchmark for transparency and quality in end-of-life care, a sector recently plagued by systemic fraud that has cost taxpayers billions and endangered vulnerable patients.

The announcement comes as federal agencies intensify their crackdown on unscrupulous hospice operators. With recent enforcement actions from the Centers for Medicare & Medicaid Services (CMS) and the Department of Justice (DOJ) revealing widespread schemes, Empassion’s new program enters the fray as a market-driven solution to a problem that has so far evaded a complete regulatory fix.

“Empassion Assured sets a new standard for hospice trustworthiness,” said Robin Heffernan, co-founder and CEO of Empassion, in a statement. “With hospice fraud rising and traditional safeguards proving insufficient, patients and payers deserve a reliable way to know whether a provider not only exists — but performs with dignity, ethics, and measurable quality.”

A System in Crisis: The High Cost of Fraud

The need for a more reliable verification system is underscored by staggering statistics. In fiscal year 2023 alone, fraudulent hospice claims cost the U.S. an estimated $3.4 billion. These are not isolated incidents but often organized schemes that exploit the system's vulnerabilities. Common types of fraud include enrolling patients who are not terminally ill, billing for services never rendered, paying illegal kickbacks for patient referrals, and keeping patients enrolled long after they cease to be eligible.

These practices not only drain Medicare funds but also inflict profound harm on patients and their families. Individuals improperly enrolled in hospice may be deprived of curative care they would otherwise be eligible for, while others receive substandard services from providers more focused on profits than patient comfort. Government reports have highlighted significant quality-of-care deficiencies even in the absence of outright fraud, with a 2024 Government Accountability Office (GAO) report finding that about 15% of hospices had serious quality deficiencies between 2017 and 2022.

Federal and state regulators have been escalating their response. CMS has implemented a Provisional Period of Enhanced Oversight (PPEO) for new hospices in states identified as fraud “hotbeds,” including California, Texas, Arizona, and Nevada. In California, authorities have revoked hundreds of hospice licenses and filed numerous criminal charges. However, the press release for Empassion Assured notes that existing oversight—often limited to initial licensure and episodic surveys—leaves “sizable gaps that fraudsters and bad actors can exploit.”

Beyond the Badge: A New Model of Continuous Evaluation

Empassion Assured aims to fill those gaps by moving beyond periodic check-ins. While established accreditation bodies like The Joint Commission and the Community Health Accreditation Partner (CHAP) offer rigorous evaluations that can grant providers “deeming authority” for Medicare participation, Empassion’s program emphasizes continuous, real-world performance monitoring.

The certification is built around the new “Empassion Bill of Rights for Hospice Care,” which requires providers to adhere to six core principles. These include mandates for compliant eligibility determination, ethical billing practices, and transparent reporting of performance data. Crucially, the program requires ongoing evaluation of clinical outcomes, operational performance, and patient experience, rather than relying on infrequent site visits.

Another key principle is the use of post-election feedback, where patients and families are surveyed throughout their time in hospice to validate quality in real time. Providers that meet these continuously monitored standards will earn the Empassion Assured badge for use in marketing and communications, signaling their commitment to a higher standard of care.

“Empassion Assured isn’t just a certification — it’s a market signal,” said Alicia Bloom, COO of Empassion. “It allows providers who consistently do the right thing to stand out, while giving payers confidence that quality and integrity are being actively monitored.”

The 'Gold Card' Gambit: Reshaping Payer Networks

The program’s most significant impact may be on the business side of healthcare. Empassion is positioning its certification as an essential tool for payers—including Medicare Advantage plans—to build preferred or “Gold Card” hospice networks. Such networks allow payers to direct patients toward a curated list of high-performing providers, preserving patient choice while confidently weeding out fraudulent or underperforming agencies.

For payers, the benefits are clear: reduced exposure to fraud, waste, and abuse, and greater assurance that their members are receiving quality care. This aligns with the broader shift in healthcare from fee-for-service models to value-based care, where providers are rewarded for better patient outcomes, not just the volume of services delivered.

For hospice providers, earning the Empassion Assured certification could become a critical competitive differentiator. In a market where high-quality agencies struggle to distinguish themselves from bad actors, the badge offers a tangible way to build trust with referring physicians, hospitals, and patients. As the nation’s largest network of at-home palliative and hospice care providers, operating in 45 states, Empassion is well-positioned to drive adoption of its new standard.

Looking ahead, the company is exploring the publication of graded hospice performance tiers, a move that would bring even greater transparency to the sector. By creating a clear, data-driven hierarchy of provider quality, Empassion aims to empower all stakeholders—patients, families, and payers alike—to make more informed decisions in the fragile and often confusing world of end-of-life care.