H. R. 133—1823 
‘‘(2) PUBLIC TRANSPARENCY OF SURVEY AND CERTIFICATION 
INFORMATION.— 
‘‘(A) SUBMISSION OF INFORMATION TO THE SECRETARY.— 
‘‘(i) IN
GENERAL.—Each State or local survey 
agency, and each national accreditation body with 
respect to which the Secretary has made a finding 
under section 1865(a) respecting the accreditation of 
a hospice program by such body, shall submit, in a 
form and manner, and at a time, specified by the 
Secretary for purposes of this paragraph, information 
respecting any survey or certification made with 
respect to a hospice program by such survey agency 
or body, as applicable. Such information shall include 
any inspection report made by such survey agency 
or body with respect to such survey or certification, 
any enforcement actions taken as a result of such 
survey or certification, and any other information 
determined appropriate by the Secretary. 
‘‘(ii) REQUIRED INCLUSION OF SPECIFIED FORM.— 
With respect to a survey under this subsection carried 
out by a national accreditation body described in clause 
(i) on or after October 1, 2021, information described 
in such clause shall include Form CMS-2567 (or a 
successor form), along with such additional information 
determined appropriate by such body. 
‘‘(B) PUBLIC DISCLOSURE OF INFORMATION.—Beginning 
not later than October 1, 2022, the Secretary shall publish 
the information submitted under subparagraph (A) on the 
public website of the Centers for Medicare & Medicaid 
Services in a manner that is prominent, easily accessible, 
readily understandable, and searchable. The Secretary 
shall provide for the timely update of such information 
so published. 
‘‘(3) CONSISTENCY OF SURVEYS.—Each State and the Sec-
retary shall implement programs to measure and reduce 
inconsistency in the application of survey results among sur-
veyors. 
‘‘(4) SURVEY TEAMS.— 
‘‘(A) IN GENERAL.—In the case of a survey conducted 
under this subsection on or after October 1, 2021, by more 
than 1 individual, such survey shall be conducted by a 
multidisciplinary team of professionals (including a reg-
istered professional nurse). 
‘‘(B) PROHIBITION OF CONFLICTS OF INTEREST.—Begin-
ning October 1, 2021, a State may not use as a member 
of a survey team under this subsection an individual who 
is serving (or has served within the previous 2 years) 
as a member of the staff of, or as a consultant to, the 
program surveyed respecting compliance with the require-
ments of section 1861(dd) or who has a personal or familial 
financial interest in the program being surveyed. 
‘‘(C) TRAINING.—The Secretary shall provide, not later 
than October 1, 2021, for the comprehensive training of 
State and Federal surveyors, and any surveyor employed 
by a national accreditation body described in paragraph 
(2)(A)(i), in the conduct of surveys under this subsection, 
including training with respect to the review of written
H. R. 133—1824 
plans for providing hospice care (as described in section 
1814(a)(7)(B)). No individual shall serve as a member of 
a survey team with respect to a survey conducted on or 
after such date unless the individual has successfully com-
pleted a training and testing program in survey and certifi-
cation techniques that has been approved by the Secretary. 
‘‘(5) FUNDING.—The Secretary shall provide for the transfer, 
from the Federal Hospital Insurance Trust Fund under section 
1817 to the Centers for Medicare & Medicaid Services Program 
Management Account, of $10,000,000 for each fiscal year (begin-
ning with fiscal year 2022) for purposes of carrying out this 
subsection and subsection (b). Sums so transferred shall remain 
available until expended. Any transfer pursuant to this para-
graph shall be in addition to any transfer pursuant to section 
3(a)(2) of the Improving Medicare Post-Acute Care Trans-
formation Act of 2014. 
‘‘(b) SPECIAL FOCUS PROGRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall conduct a special 
focus program for enforcement of requirements for hospice pro-
grams that the Secretary has identified as having substantially 
failed to meet applicable requirements of this Act. 
‘‘(2) PERIODIC SURVEYS.—Under such special focus program, 
the Secretary shall conduct surveys of each hospice program 
in the special focus program not less than once every 6 months. 
‘‘(c) ENFORCEMENT.— 
‘‘(1) SITUATIONS INVOLVING IMMEDIATE JEOPARDY.—If the 
Secretary determines on the basis of a standard survey or 
otherwise that a hospice program that is certified for participa-
tion under this title is no longer in compliance with the require-
ments specified in section 1861(dd) and determines that the 
deficiencies involved immediately jeopardize the health and 
safety of the individuals to whom the program furnishes items 
and services, the Secretary shall take immediate action to 
ensure the removal of the jeopardy and correction of the defi-
ciencies or terminate the certification of the program, and may 
provide, in addition, for 1 or more of the other remedies 
described in paragraph (5)(B). 
‘‘(2) SITUATIONS
NOT
INVOLVING
IMMEDIATE
JEOPARDY.— 
If the Secretary determines on the basis of a standard survey 
or otherwise that a hospice program that is certified for partici-
pation under this title is no longer in compliance with the 
requirements specified in section 1861(dd) and determines that 
the deficiencies involved do not immediately jeopardize the 
health and safety of the individuals to whom the program 
furnishes items and services, the Secretary may (for a period 
not to exceed 6 months) impose remedies developed pursuant 
to paragraph (5)(A), in lieu of terminating the certification 
of the program. If, after such a period of remedies, the program 
is still no longer in compliance with such requirements, the 
Secretary shall terminate the certification of the program. 
‘‘(3) PENALTY FOR PREVIOUS NONCOMPLIANCE.—If the Sec-
retary determines that a hospice program that is certified for 
participation under this title is in compliance with the require-
ments specified in section 1861(dd) but, as of a previous period, 
did not meet such requirements, the Secretary may provide 
for a civil money penalty under paragraph (5)(B)(i) for the
H. R. 133—1825 
days in which the Secretary finds that the program was not 
in compliance with such requirements. 
‘‘(4) OPTION TO CONTINUE PAYMENTS FOR NONCOMPLIANT 
HOSPICE
PROGRAMS.—The Secretary may continue payments 
under this title with respect to a hospice program not in compli-
ance with the requirements specified in section 1861(dd) over 
a period of not longer than 6 months, if— 
‘‘(A) the State or local survey agency finds that it 
is more appropriate to take alternative action to assure 
compliance of the program with such requirements than 
to terminate the certification of the program; 
‘‘(B) the program has submitted a plan and timetable 
for corrective action to the Secretary for approval and the 
Secretary approves the plan of corrective action; and 
‘‘(C) the program agrees to repay to the Federal 
Government payments received under this title during such 
period if the corrective action is not taken in accordance 
with the approved plan and timetable. 
The Secretary shall establish guidelines for approval of correc-
tive actions requested by hospice programs under this para-
graph. 
‘‘(5) REMEDIES.— 
‘‘(A) DEVELOPMENT.— 
‘‘(i) IN GENERAL.—Not later than October 1, 2022, 
the Secretary shall develop and implement— 
‘‘(I) a range of remedies to apply to hospice 
programs under the conditions described in para-
graphs (1) through (4); and 
‘‘(II) appropriate procedures for appealing 
determinations relating to the imposition of such 
remedies. 
Remedies developed pursuant to the preceding sen-
tence shall include the remedies specified in subpara-
graph (B). 
‘‘(ii) CONDITIONS
OF
IMPOSITION
OF
REMEDIES.— 
Not later than October 1, 2022, the Secretary shall 
develop and implement specific procedures with respect 
to the conditions under which each of the remedies 
developed under clause (i) is to be applied, including 
the amount of any fines and the severity of each of 
these remedies. Such procedures shall be designed so 
as to minimize the time between identification of defi-
ciencies and imposition of these remedies and shall 
provide for the imposition of incrementally more severe 
fines for repeated or uncorrected deficiencies. 
‘‘(B) SPECIFIED REMEDIES.—The remedies specified in 
this subparagraph are the following: 
‘‘(i) Civil money penalties in an amount not to 
exceed $10,000 for each day of noncompliance by a 
hospice program with the requirements specified in 
section 1861(dd). 
‘‘(ii) Suspension of all or part of the payments 
to which a hospice program would otherwise be entitled 
under this title with respect to items and services 
furnished by a hospice program on or after the date 
on which the Secretary determines that remedies
H. R. 133—1826 
should be imposed pursuant to paragraphs (1) and 
(2). 
‘‘(iii) The appointment of temporary management 
to oversee the operation of the hospice program and 
to protect and assure the health and safety of the 
individuals under the care of the program while 
improvements are made in order to bring the program 
into compliance with all such requirements. 
‘‘(C) PROCEDURES.— 
‘‘(i) CIVIL MONEY PENALTIES.— 
‘‘(I) IN
GENERAL.—Subject to subclause (II), 
the provisions of section 1128A (other than sub-
sections (a) and (b)) shall apply to a civil money 
penalty under this subsection in the same manner 
as such provisions apply to a penalty or proceeding 
under section 1128A(a). 
‘‘(II) RETENTION OF AMOUNTS FOR HOSPICE PRO-
GRAM IMPROVEMENTS.—The Secretary may provide 
that any portion of civil money penalties collected 
under this subsection may be used to support 
activities that benefit individuals receiving hospice 
care, including education and training programs 
to ensure hospice program compliance with the 
requirements of section 1861(dd). 
‘‘(ii) SUSPENSION OF PAYMENT.—A finding to sus-
pend payment under subparagraph (B)(ii) shall termi-
nate when the Secretary finds that the program is 
in substantial compliance with all requirements of sec-
tion 1861(dd). 
‘‘(iii) TEMPORARY
MANAGEMENT.—The temporary 
management under subparagraph (B)(iii) shall not be 
terminated until the Secretary has determined that 
the program has the management capability to ensure 
continued compliance with all the requirements 
referred to in such subparagraph. 
‘‘(D) RELATIONSHIP TO OTHER REMEDIES.—The remedies 
developed under subparagraph (A) are in addition to sanc-
tions otherwise available under State or Federal law and 
shall not be construed as limiting other remedies, including 
any remedy available to an individual at common law.’’. 
(2) AVAILABILITY OF HOSPICE ACCREDITATION SURVEYS.— 
Section 1865(b) of the Social Security Act (42 U.S.C. 1395bb(b)) 
is amended by inserting ‘‘or, beginning on the date of the 
enactment of the Consolidated Appropriations Act, 2021, a hos-
pice program’’ after ‘‘home health agency’’. 
(3) STATE PROVISION OF HOSPICE PROGRAM INFORMATION.— 
(A) IN GENERAL.—Section 1864(a) of the Social Security 
Act (42 U.S.C. 1395aa(a)) is amended in the sixth sen-
tence— 
(i) by inserting ‘‘and hospice programs’’ after 
‘‘information on home health agencies’’; 
(ii) by inserting ‘‘or the hospice program’’ after 
‘‘the home health agency’’; 
(iii) by inserting ‘‘or the hospice program’’ after 
‘‘with respect to the agency’’; and 
(iv) by inserting ‘‘and hospice programs’’ after 
‘‘with respect to home health agencies’’.