CMS expanded its hospice oversight programs in December 2025 in its ongoing effort to root out hospice fraud, waste and abuse. While the structure of the Provisional Period of Enhanced Oversight (PPEO) and Targeted High-Risk Hospice (THRH) programs remain unchanged, the initiatives now apply to providers in Georgia and Ohio. 
 
Agencies in Arizona, California, Nevada and Texas were already subject to PPEO, under which newly enrolled hospice agencies are subject to enhanced oversight for 30 days to a year and may face penalties up to exclusion from Medicare if found to be noncompliant with conditions of payment.  
 
Existing hospices in these states also see prepayment reviews under the THRH program. Agencies are subject to THRH audits, which look at a small number of an agency’s claims to identify and prevent improper billing and payments, at CMS’ discretion. 
 
To view CMS’s fact sheet on the expansion for new hospices, visit https://bit.ly/49E3sdI.  
 
To learn more about the expansion for existing hospices, visit https://bit.ly/3N4sYjw.  
 
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