Last spring, Capital Tonight sounded an alarm about for-profit hospice care.

The Federal Bureau of Investigation (FBI) had just issued public warnings about for-profit hospice fraud in four states; it was alerting consumers to a scam in which patients were being enrolled without their knowledge by recruiters who were “selling” hospice to people who weren’t eligible.

Hospice fraud like this has also been extensively reported by The New Yorker and Pro Publica.

After Gov. Kathy Hochul twice vetoed a bill preventing the expansion of for-profit hospice in New York, a new bill (S.3437/ A. 565) is being introduced by the chair of the state Senate Finance Committee, Liz Krueger, and chair of the state Assembly Health Committee, Amy Paulin.

“If a family is faced with a loved one that is dying, they should not also be faced with the possible incentive of money,” Assemblymember Paulin told Capital Tonight. 

There are a variety of drawbacks to for-profit care, and there is clear data that shows profit motives drive for-profit hospice to neglect patient care and prioritize volume over quality.

In her 2022 veto message, the governor stated “Data suggests that hospice care is underutilized in New York in comparison to other states, straining other elements of our health care system,” and therefore, New York need more hospices. 

Indeed, New York state has the lowest hospice utilization rate in the country, but according to the president and CEO of the Hospice & Palliative Care Association of New York State, Jeanne Chirico, a greater number of hospices is not the answer.

“That is such a common misperception. More hospices does not equal more utilization,” Chirico said. “In other states they have found that same issue. It can wear down and erode the hospices that are already in existence because our workforce is so short, that we are really robbing Peter to pay Paul.”

New York is currently home to two for-profit hospices that have shown they are good actors, but Chirico and Paulin told Capital Tonight that they fear opening up the doors to more for-profits may overwhelm the state Department of Health’s assessment process for hospice care called the “Certificate of Need,” or CON.

The CON process reviews applications, provides for public comment and ensures that hospice operators don’t have a history of fraud or abuse.

“Unfortunately, the CON process still needs some support and guardrails,” Chirico explained. “There are a lot of ways to hide the private-equity, venture-backed capitalists that actually own the hospice.”

Chirico said it is both difficult and time-consuming for DOH to research ownership structures that are purposely obtuse and complex by design. 

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