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Home-based care leaders at an August 2026 FUTURE panel said tougher fraud enforcement is pushing providers to strengthen documentation, enrollment records and audit readiness. They argued that consistent compliance practices may help distinguish legitimate operators, while warning that enforcement can affect providers even without a fraud finding.
Home-based care operators are strengthening documentation, enrollment records and audit readiness as federal fraud enforcement intensifies, industry leaders said at an Aug. 27 panel. They said the heightened scrutiny may give providers with strong compliance practices a way to distinguish themselves, although enforcement can also reach organizations before a fraud finding.
Katie Wehri, vice president of regulatory affairs, quality and compliance for the National Alliance for Care at Home, said enforcement has shifted from a sequence in which a fraud finding preceded charges and action. “What’s happening now is they’re going after folks without a finding of fraud,” she said. Providers are also contending with increased oversight, enrollment restrictions and proposed changes to affiliation disclosures. Wehri said suspensions or revocations could be tied to an organization’s location or business relationships.
That approach can make it harder to separate errors by otherwise compliant providers from intentional wrongdoing, said Gayle Devin, CEO of Home Care Delivered, a specialty medical supplier that delivers products to patients’ homes. She said organizations make mistakes, but argued that regulators should distinguish an isolated error from a pattern of deliberate conduct. Devin said the Centers for Medicare & Medicaid Services should use data to identify where fraud is occurring and address patterns, while considering whether some providers need re-education rather than enforcement aimed at bad actors.
Brian Holzer, CEO of Freedom Senior Services, said companies should expect continued scrutiny and prepare for compliance checks. His organization plans to introduce unannounced internal audits, he said. Devin said Home Care Delivered has increased attention to eligibility verification, policy requirements and claims review as unannounced surveys and audits have grown. She also urged companies to keep employees informed about regulatory changes and their responsibilities.
Compliance as a Competitive Signal
The enforcement climate affects more than providers suspected of fraud: tighter enrollment rules, audits and potential suspensions can shape how legitimate home-based care organizations operate and demonstrate reliability. A documented compliance program may help a provider explain its practices to regulators and reassure customers, but it does not by itself guarantee protection from scrutiny.
For patients and referral partners, the distinction matters because enforcement actions can disrupt access to services. Wehri said providers can explain to CMS when their services fill a gap in care, while Holzer said responsible operators should welcome scrutiny if it helps recognize investment in proper practices. Those are the panelists’ views; the source report does not establish that regulators or customers will reward providers for compliance efforts.
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Why Providers Are Preparing Now
The panel discussion took place at FUTURE on Aug. 27, 2026, amid what the report describes as a significant increase in fraud enforcement affecting home-based care. Wehri represents the National Alliance for Care at Home, a member network covering home health, hospice, Medicaid home- and community-based care and related professionals.
Home Care Delivered is based in Richmond, Virginia. Freedom Senior Services, based in Louisville, Kentucky, provides home care, adult day health care and other services across Kentucky, Ohio, Pennsylvania, Tennessee and Indiana. The organizations operate in different parts of the home-based care sector, but their leaders described similar pressure to keep records, policies and employees ready for closer review.
““But there’s a difference between a mistake and patterns.””
— Gayle Devin, CEO of Home Care Delivered
How Enforcement Will Be Applied
The panel report does not detail the scale of enforcement actions, identify specific providers affected or quantify changes in audits, suspensions or revocations. It also does not specify the proposed affiliation-disclosure changes or when they might take effect. The circumstances under which a provider could face action because of its location or business ties remain unclear from the report.
It is also unknown whether stronger documentation or internal audits will alter regulators’ decisions or help providers avoid interruptions. The panelists described their experiences and recommendations; their comments do not establish how CMS will apply enforcement across different organizations or cases.
Preparing for Ongoing Reviews
Freedom Senior Services plans to implement unannounced internal audits, according to Holzer. Devin said Home Care Delivered is increasing checks on eligibility, policy adherence and claims, while urging employers to explain regulatory duties to staff. The panelists expect providers to remain ready for external reviews, but the report gives no timetable for specific federal policy changes or future enforcement actions.
Key Questions
What are home-based care providers changing?
Panelists described stronger documentation, eligibility verification, claims review and audit preparation, along with staff education on regulatory duties.
Can a provider face enforcement without a fraud finding?
Wehri said providers are being pursued without a fraud finding. The report does not specify the legal or factual circumstances of individual cases.
How could compliant providers distinguish themselves?
Wehri said providers can explain their practices to CMS, including how their services fill a care gap. Leaders also pointed to records and policies that show how an organization operates.
What remains unknown about the crackdown?
The report does not quantify enforcement activity or explain the details and timing of proposed affiliation-disclosure changes. It also does not say whether compliance investments will affect enforcement outcomes.
Source: homehealthcarenews.com
