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Capitol Corner | May 2026

Date postedMay 5, 2026
Posted By: Soua Vang Bulletin,

What Providers Need to Know Now - Hospice Suspensions, PDN Rates, and Workforce Policy

 

Providers across California are navigating a rapidly evolving environment - from hospice payment suspensions to ongoing challenges in Medi-Cal reimbursement and workforce policy. What we are seeing in real time is the operational and financial strain this is placing on providers who are delivering care with integrity.

 

Recent actions tied to hospice fraud, waste, and abuse (FWA) enforcement, particularly Medicare payment suspensions are moving quickly and, in many cases, without clear or consistent communication.

 

Through direct outreach, webinars, and our recent listening session, CAHSAH is hearing consistent concerns from the field. Providers are reporting payment suspensions both with and without formal notice. Some have received payments that were later recouped, creating immediate cash flow challenges. There is also widespread confusion around Qlarant letters - what they mean, how to respond, and the timelines providers are expected to meet.

 

In response, CAHSAH has been actively engaged on your behalf.

 

We have elevated these concerns directly with CMS through formal communication, emphasizing the need for clarity, consistency, and a balanced approach that does not unintentionally harm compliant providers. We have also worked to ensure your perspective is represented publicly, including recent coverage in the media.

 

At the same time, our priority has been ensuring you have the information and support you need right now. Our recent webinar on Medicare Payment Suspensions provided immediate guidance on how to interpret Qlarant letters and navigate the critical first steps. We followed this with a virtual listening session that brought together nearly 150 providers to share real-time experiences and identify common challenges. These insights are directly informing our ongoing advocacy and resources.

 

To make this guidance more accessible, we released a dedicated episode of At the Table with CAHSAH, “Hospice Suspensions – What You Need to Know,” focused on what providers should be doing now and how to approach this environment strategically.

 

CAHSAH is also working closely with state regulators to ensure providers have clarity on their obligations. We have met with the California Department of Public Health to better understand expectations related to patient care and operations during payment suspensions.

 

One critical issue providers must be aware of: if you are impacted and have no choice but to transfer patients, you must ensure continuity of care and follow all required notification protocols, including informing appropriate local representatives where applicable. Failure to follow required processes could result in regulatory action, including potential risk to licensure. These are complex situations, and providers should proceed carefully and in coordination with legal and compliance guidance.

 

While much of the immediate focus has been on hospice, CAHSAH is also advancing advocacy on another urgent front - Medi-Cal private duty nursing (PDN) rates. As outlined in our recent budget request letter, current PDN reimbursement levels are not sustainable and are contributing to workforce shortages and reduced access to care for medically complex patients.

 

The request for a 40% rate increase reflects the real cost of delivering continuous skilled nursing care in the home. More importantly, this investment is projected to generate significant cost savings to the state by preventing avoidable hospitalizations and institutional care while ensuring patients can safely remain in their homes.

 

In addition, CAHSAH is actively engaged in workforce policy, SB 1057. Our focus is on ensuring clarity in how requirements are implemented and maintaining the safety and stability of care for vulnerable patients who rely on consistent, qualified caregivers in the home.

 

These issues are directly connected. When reimbursement, regulation, and workforce policy are not aligned with care delivery, the result is the same: reduced access, increased system strain, and risk to vulnerable patients. CAHSAH is focused on ensuring policy decisions across all fronts support stability, access, and quality care.

 

While CAHSAH is actively working to provide clarity and support, each provider’s situation may differ, and decisions should be made based on your organization’s specific circumstances.

 

In addition, we continue to urge providers to report any suspected unlicensed operators. Protecting the integrity of care requires a collective effort, and identifying bad actors is a key part of that responsibility.

 

This situation continues to evolve, and CAHSAH is actively monitoring developments, engaging with regulators, and advocating for practical solutions that support providers while maintaining program integrity.

 

What You Should Do Now

  • Act quickly if you receive any notification - timelines matter
  • Ensure documentation and compliance processes are in order
  • Engage appropriate legal and compliance support as needed
  • Follow proper protocols if transferring patients to ensure continuity of care and regulatory compliance

 

Take Action

 

At a time like this, your voice matters. CAHSAH remains committed to standing alongside our members - advocating, informing, and ensuring you are equipped to navigate what comes next. Thank you for all you do every day for patients.

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