Challenging the CMS Hospice Special Focus Program
The Texas Association for Home Care & Hospice (TAHC&H) has joined a multi-state coalition to challenge the Centers for Medicare & Medicaid Services’ (CMS) Hospice Special Focus Program (SFP) Final Rule, filing suit in the U.S. District Court for the Southern District of Texas. This coalition seeks to halt the implementation of the SFP, citing it as both unlawful and arbitrary.
Hospice SFP Update:
March 25th, 2025
Dear Members,
​
We are pleased to report that a judge signed our order for a stay of the SFP litigation. After we filed a Temporary Restraining Order, CMS voluntary withdrew the SFP List. In a joint motion to stay the SFP litigation, CMS pledged that it will not resume implementation of the SFP Final Rule in 2025 while it considers whether to resume implementing the SFP Final Rule in future years or take other action, such as undertaking a new rulemaking. On March 21, 2025, based on CMS's representations, the district court granted the motion to stay the litigation.
We are pleased that CMS has committed not to resume the Special Focus Program this year, such that the SFP litigation is paused for now. This is an important step forward in our ongoing efforts to work with CMS on developing a SFP that truly serves patients and fulfills Congress' intent to identify and improve poor-performing hospices.
As your state trade association, we are committed to fulfilling our mission, to advocate for ethical practices, quality, and economic viability of licensed home care and hospice for every member who provides care in the home.
So, what is next? Within the next (90) days of the Court's issuance of the order, both parties must submit a joint status report advising the court as to the Parties' respective positions regarding a continued stay and unless one of the parties' changes positions, the order will stay in place.
February 14th, 2025
Dear Members,
​
We are excited to announce that CMS has updated its site and announced that the implementation of the hospice special focus program has ceased. We have been notified by selected providers that they are receiving notice from CMS as well. See the announcement here.
​
Hospice Special Focus Program
Effective February 14, 2025, implementation of the Hospice Special Focus Program for CY 2025 has ceased so that CMS may further evaluate the program. Please contact QSOG_Hospice@cms.hhs.gov for policy questions.
​
This is a terrific development, providing much of the relief sought by our TRO motion. This development does not end the litigation, however, because our suit seeks to have the entire Hospice SFP Final Rule withdrawn. CMS has not withdrawn the Final Rule at this time, so we anticipate continuing the litigation until that goal is achieved.
​
For now, we are very pleased to see that CMS has ceased implementation of the Hospice Special Focus Program. We stand ready to work with CMS and other stakeholders to ensure the Program is revised to meet the purposes that Congress intended.
Media Advisory
"TAHC&H Joins Multi-State Coalition to Challenge CMS Hospice Special Focus Program as Unlawful and Arbitrary"
A multi-state coalition of hospices and hospice associations, including the Texas Association for Home Care & Hospice (TAHC&H), filed suit in the U.S. District Court for the Southern District of Texas to challenge the Centers for Medicare & Medicaid Services’ (CMS) Hospice Special Focus Program (SFP) Final Rule and its implementation as unlawful and arbitrary. The plaintiffs also seek a preliminary injunction to halt the Special Focus Program.
“TAHC&H and coalition partners filed this suit because, despite Members of Congress and stakeholders repeated warnings to CMS of the problems with the SFP Final Rule, CMS pressed ahead with a deeply flawed approach that erroneously results in some of the highest performing, mission-focused hospice programs being publicly listed as poor performers”, said Rachel Hammon, TAHC&H’s Executive Director.
“On behalf of our hospice members, over the past year TAHC&H and partner associations have submitted extensive comments to CMS expressing concerns that the algorithm developed to select hospices for the Special Focus Program (SFP) to identify ‘poor-performing’ hospices could result in high-quality, mission-driven providers being inappropriately placed on the list. Regrettably, our concerns have become a reality,” said Hammon.
TAHC&H represents over 1,200 licensed home- and community-support agencies. At least 142 are involved in hospice programs. TAHC&H hospice-program members range from small businesses with a single licensed and Medicare-certified facility in the State to large businesses with many licensed and Medicare-certified facilities across the State and include both non-profit and for-profit organizations that provide hospice services throughout Texas, including in underserved communities, both rural and urban.
“In full support of our membership, TAHC&H is asking CMS to withdraw immediately its SFP selections of hospices, as well as the SFP List and underlying data, and also to withdraw and revise the SFP Final Rule to align with Congressional intent, focusing on hospices with the worst record of substantial non-compliance with Medicare requirements” Hammon emphasized.
Texas Association for Home Care & Hospice (TAHC&H) is an association of Texas Licensed home-care and hospice agencies, organizations, and individual professionals. TAHC&H advocates for ethical practices, quality, and economic viability of licensed home-care and hospice providers to enhance the well-being of individuals and their families throughout Texas. TAHC&H brings together organizations and individuals in a shared commitment to every Texas citizen in need of quality, affordable in-home services.