LAS VEGAS (KTNV) — The Nevada Health Authority is pausing new state licenses for hospice and home-health providers and is putting a moratorium on new enrollments for Nevada Medicaid.
State officials said the pause will remain in place until they can validate and confirm the legitimacy of current providers. Upon federal approval, the moratorium will be in effect for at least six months.
"Protecting taxpayer dollars and preserving access to quality healthcare services for Nevadans requires us to confront fraud head-on. Bad actors who use hospice and home-health programs as vehicles to steal public funds are undermining care for those who need it most," Gov. Joe Lombardo said in a press release. "I support the Nevada Health Authority's decisive action to identify fraudulent providers, strengthen accountability, and work alongside law enforcement to pursue criminal prosecutions wherever wrongdoing is found. Nevada will not tolerate fraud, waste, or abuse in our public programs."
"This temporary pause across state licensing and Medicaid is necessary to allow us time to get a handle on Medicaid billing fraud in Nevada for these important services," Ann Jensen, Nevada Medicaid Director, said in a press release. "Without it, we will continue to lose out on the time needed to stop millions in scarce public resources from being stolen from bad actors who are posing as legitimate, licensed hospice and home health providers."
This decision is not a surprise. Last month, the Centers for Medicare & Medicaid Services announced a "six-month, nationwide data-driven moratoria on new Medicare enrollment for hospices and home health agencies (HHAs)."
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According to a press release, over the next six months, CMS officials will "intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud. This nationwide approach will also eliminate the ability of bad actor operators to evade detection by simply shifting across state lines."
The Nevada Hospital Association also flagged this change was coming in one of their weekly wrap-ups last month.
"For Nevada hospital systems that operate hospice or home health lines, or that have planned new Medicare-certified enrollment, the moratorium takes effect immediately," the statement says in part. "Majority ownership changes are also within the moratorium's scope, which has direct implications for any pending hospice or home health agency acquisition. Systems with affected transactions in progress should consult compliance and legal counsel on the specific parameters before proceeding."
All of these pauses are coming after major cases of widespread fraud were found in other states, including California.
A federal anti-fraud task force has suspended approximately 800 hospices and HHAs suspected of fraud across the Los Angeles area that were responsible. for $1.4 billion in Medicare spending last year, with $70 million in suspended funds. Gov. Gavin Newsom's office also stated over 280 hospice licenses have been revoked over the past two years, 300 providers are under investigation, and 284 people have been arrested.
Have Nevada lawmakers looked into this problem before?
Potential hospice fraud has been on the radar for years. In 2023, federal regulators rolled out enhanced oversight for new hospices in Nevada and three other states.
Officials with Nathan Adelson Hospice have also previously sounded the alarm. They sent a letter to Gov. Joe Lombardo in April 2024 asking for an Executive Order to fix the issue. Copies of that letter were also sent to Tick Segerblom, who was then-Chair of the Clark County Board of Commissioners, Carolyn Goodman, then-Mayor for the City of Las Vegas, Michelle Romero, Mayor for the City of Henderson, and Pamela Goynes-Brown, Mayor for the City of North Las Vegas.
You can read that letter below.
In addition to that, during the 2025 legislative session, Nevada lawmakers passed Assembly Bill 161, which was signed into law. The law included changes to hospice care, including a requirement for obtaining informed consent to treatment.
You can read the bill below.
Assemblywoman Dr. Rebecca Edgeworth, who introduced the bill, previously told Channel 13 this issue was important to address due to "an influx of bad hospices that have come into this community and into our state."
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"The growing number of providers has introduced unnecessary fraud and abuse that threatens the safety of the most vulnerable members of our community. Driven by greed, some of these new agencies are giving horrific care to people at their most defenseless and right at the end of their lives," Edgeworth told lawmakers in 2025. "It's become apparent to me that the perfect victims of this unacceptable treatment are people who are dying and can't complain, family members who are too brokenhearted to complain, and that assumes they even know who to complain to."
Karen Rubel, who was the President and CEO of Nathan Adelson Hospice in 2025, told lawmakers they had already spotted instances of fraud.
"Hospice companies will stay under the audit radar by only enrolling a certain number of patients so they are not required to report quality scores to CMS," Rubel explained. "As an example, a review in Clark County found multiple hospices at the same address without a corresponding increase in the number of patients that they provided care to as well as specific individuals holding top management positions for multiple hospice entities at the same time and not having to report those quality scores."
Rubel also said they tracked new hospice business licenses that had been issued by the Nevada Secretary of State's website and from 2022 through 2025, that number has climbed.
Rubel said a lack of care at some of those facilities has led to more and more patients being transferred to Nathan Adelson Hospice.
So who is supposed to be overseeing and inspecting these facilities?
Dan Musgrove, a consultant for Nathan Adelson Hospice, told lawmakers that in Nevada, it's the Department of Public and Behavioral Health, specifically the Bureau of Health Care Quality and Compliance.
"Because of their responsibility, usually, they're complaint-driven," Musgrove said. "CMS does have a responsibility to certify these folks are good, they follow laws. HCQC acts as the agent although we have learned that there have been inspector generals brought to Nevada by CMS to do some inspections. The trouble is we just haven't seen any action at this point."
Musgrove said Nathan Adelson Hospice officials have reported every complaint they get and HCQC does do a good job of investigating those specific complaints.
However...
"It's hard to get folks to complain about something they're not aware of, that they've been taken advantage of," Musgrove said. "That's why we really, of anything of this bill, we want it to be a patient bill of rights so they understand what they should get and should demand and therefore, they know what to complain about."
And as for why those agencies don't do spontaneous facility checks or inspections...
"They get their accreditation to open their doors and start taking their first patient that they're going to send a bill for. But then, after that, there's not a regular type of audit or visit by that same accrediting organization unless you're over a certain size of hospice," Rubel explained. "So a lot of these bad actors can fly under the radar because they get their one accreditation and then nobody comes back and does any kind of follow-up."
What happens during this six-month moratorium?
Over the next six months, state staff will be doing on-site reviews of all Medicaid-enrolled hospice and home-health providers to identify any instances of potential Medicaid billing and payment fraud.
That includes working with the Attorney General's Office, federal partners, and law enforcement to initiate criminal investigations.
According to the Nevada Health Authority, in the interest of ensuring access to critical services, Nevada Medicaid is allowing some new providers to apply for an exemption to the state moratorium if it will support improved access to hospice and home-health services in Nevada's rural and underserved communities.