Hospice Special Focus Program (SFP) Suspended

Understanding the SFP

The Hospice Special Focus Program (SFP), initiated by the Centers for Medicare & Medicaid Services (CMS), aims to enhance the quality of hospice care by identifying and monitoring hospices that perform poorly based on selected quality indicators[1].

This program is mandated by the Consolidated Appropriations Act of 2021 and seeks to ensure that hospices meet national health and safety standards, thereby improving care for patients and their families[1].

The SFP involves increased regulatory oversight and enforcement actions for hospices that fail to meet specific quality benchmarks[2]. These actions can include additional surveys, mandatory quality improvement plans, and, in severe cases, termination from the Medicare program[2].

The program's criteria and methodology are designed to identify hospices that pose a risk to patient care, ensuring they receive the necessary support and oversight to improve their services[1].

SFP Suspension & Related Lawsuit

On Feb 14, 2025, CMS and the Trump administration announced the suspension of the SFP to allow further evaluation of the program[3]. This decision comes amid a lawsuit filed by several hospice organizations against the U.S. Department of Health and Human Services (HHS). The plaintiffs, including state associations and individual hospices, argue that the criteria used to select hospices for the SFP are flawed and biased[4].

The lawsuit, filed in the U.S. District Court in the Southern District of Texas-Houston Division, challenges the SFP’s selection criteria, arguing that the algorithm disproportionately impacts larger providers by using outdated survey data and inaccurately weighting quality metrics[4].

The plaintiffs seek a preliminary injunction to halt the program, claiming it could misrepresent hospice compliance and negatively impact the quality and availability of care[5].

Implications for Hospice Care

The suspension of the SFP and the ongoing lawsuit highlight the complexities involved in regulating hospice care. While the program’s intent is to improve care quality, the methodology and criteria used must be fair and transparent to avoid unintended consequences for hospice providers.

This development could lead to significant changes in how the SFP is implemented and enforced, ultimately impacting the quality of hospice care nationwide.

As the situation evolves, hospice providers must remain vigilant and proactive. Staying informed through official CMS updates, engaging with industry associations, and preparing for possible changes in compliance requirements will be key.

This period of suspension might be an opportunity for providers to contribute to the dialogue on how best to measure and improve hospice care quality.

References

[1] Hospice Special Focus Program - CMS

[2] Overview of the Hospice Special Focus Program (SFP) | CMS

[3] [UPDATED] Trump Administration Suspends Hospice Special Focus Program

[4] Inside Hospice Organizations’ Special Focus Program Lawsuit Against HHS

[5] Hospice Organizations File Lawsuit to Halt Special Focus Program