Friday, January 15, 2021 Tucked away in the recently enacted 5,500+ page Consolidated Appropriations Act of 2021 (the “Act”) are important provisions tightening up the survey and enforcement procedures for Medicare hospice programs. The Act (Pub. L. 116-260) was signed into law on December 27, 2020. Among other things, the Act’s hospice provisions require that the Secretary of Health and Human Services (the “Secretary”), by October 1, 2022, develop intermediate sanctions, including civil monetary penalties, and impose these sanctions on Medicare-certified hospice programs in response to survey deficiencies. This spotlight on hospice survey enforcement comes as no surprise. For a few years, Congress has considered several bills to put more rigor into the Medicare survey process for hospices, including the Helping Our Senior Population in Comfort Environments Act (“HOSPICE Act”). This legislative effort was fueled by a series of recent reports that the Department of Health and Human Services’ Office of Inspector General (“OIG”) issued highlighting quality of care issues among Medicare-certified hospices. Many provisions of the HOSPICE Act were incorporated into the Act. While this development was inevitable, hospice industry representatives were able to temper the impact and ensure that some helpful provisions were included.