Few places in America are as closely tied to retirement and aging as Florida.

With one of the fastest-growing retiree populations in the country, our state depends on a healthcare system that is strong, reliable, and accessible for older adults who choose to spend their final years here.

A critical part of that system is hospice care — the compassionate, end-of-life support that helps patients manage pain and symptoms while giving families emotional support and peace of mind during life’s most difficult moments. More than 60% of Medicare beneficiaries in Florida use the Medicare hospice benefit, the second-highest utilization rate in the nation. That reflects something worth being proud of: Florida’s hospice providers are nationally recognized for delivering high-quality care.

Recently, however, hospice care has made headlines for the wrong reasons. Fraudulent provider networks in California and Texas are under federal investigation for allegedly exploiting Medicare’s hospice billing system. As a representative of Florida’s hospice community, I find these cases appalling and fully support holding bad actors accountable.

But when even a small number of fraudulent providers cheat the system, the damage spreads far beyond their home states. Taxpayers lose money, public trust erodes, and legitimate providers — along with the patients who depend on them — pay the price.

It’s important to be clear: the vast majority of hospice providers across the country are honest, mission-driven organizations doing essential work. The fraud problems appear concentrated in a handful of large markets where weak regulatory oversight has allowed criminal enterprises to slip through the cracks.

Florida is a different story. Our state has one of the most rigorous hospice oversight structures in the country. The Florida Agency for Health Care Administration (AHCA) conducts regular surveys and evaluations of hospice providers to ensure quality and compliance. Every new hospice program undergoes a thorough vetting process before opening its doors. Florida’s Certificate of Need (CON) laws add another layer of protection by requiring that new providers demonstrate a genuine community need before they can open — ensuring that every hospice operating in this state is here for the right reasons.

I recently joined other Florida hospice leaders in writing to CMS Administrator Dr. Mehmet Oz to reaffirm our commitment to fighting fraud, waste, and abuse while protecting patient access. That message echoed calls from national stakeholders urging CMS to pursue targeted oversight rather than sweeping restrictions.

Unfortunately, the federal government has now imposed a six-month nationwide moratorium on new hospice provider licensing. This broad, one-size-fits-all approach disrupts well-functioning state systems like Florida’s and risks delaying care for patients who need it most — all to address problems that are largely concentrated elsewhere.

CMS has previously acknowledged that targeted, geographically focused enforcement is the most effective way to combat localized fraud. A nationwide moratorium contradicts that approach. Rather than protecting patients, it risks cutting off access for the very people hospice is designed to serve.

The right solution is targeted enforcement — cracking down on criminal networks in the specific communities where abuse is documented, without penalizing high-performing states and the families who rely on their care.

Every Floridian deserves the assurance that when life’s most difficult moments arrive, trustworthy and compassionate care will be there. We remain committed to upholding the integrity of our hospice system, and we urge federal regulators to pursue smarter, more focused solutions that protect both patients and the providers who serve them.

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Paul Ledford is president and CEO of the Florida Hospice & Palliative Care Association.

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