Nevada Takes Decisive Action Against Hospice Fraud: A Step Toward Better End-of-Life Care

The Problem at Hand

Nevada has witnessed an alarming explosion in hospice providers—from fewer than 70 facilities in 2020 to over 270 in 2025 [1] . This rapid growth isn't driven by increasing patient needs but rather by opportunistic operators taking advantage of regulatory loopholes. When California cracked down on hospice fraud, many unscrupulous operators simply migrated to Nevada's less regulated environment [1] .

Assembly Bill 161: A Balanced Approach

Sponsored by Assemblymember Rebecca Edgeworth (R-Las Vegas), the only practicing physician in the Assembly, this bill introduces several practical measures to curb fraud while supporting legitimate hospice operations[2] [3] :

Enhanced regulatory oversight for newly licensed hospice programs during their first two years of operation

Requirements for accreditation and Medicare certification Mandatory staff training aligned with national standards

Written "Hospice Bill of Rights" disclosures to patients and families

Restrictions on transferring Medicare billing privileges within the first 60 months of licensure

The legislation targets the fraudulent practice of "license flipping," where operators sell their licenses soon after obtaining them, before regulators can detect problems[2] . This practice has been particularly common in the four fraud hotbed states: Nevada, Arizona, California, and Texas.

Protecting Patients While Supporting Ethical Business

What makes this legislation promising is its focus on targeting bad actors while allowing legitimate businesses to operate. Rather than implementing a blanket moratorium like California did, Nevada's approach recognizes that such restrictions "could potentially pose harmful impacts for legitimate new operators seeking to expand hospice access, particularly in rural regions"[2] .

The bill addresses serious issues like patients being enrolled in hospice without their knowledge or consent, which not only defrauds Medicare but also potentially deprives patients of curative treatments they might have chosen instead [2] [4] .

Moving Forward

For hospice providers operating ethically in Nevada, this legislation offers clear compliance guidelines that should actually benefit business operations in the long run. By weeding out fraudulent competitors who damage the industry's reputation, legitimate operators stand to gain both patient trust and market share.

As Dr. Edgeworth herself noted, "We expect several amendments, since there are a lot of stakeholders who want to get it right" [2] . This collaborative approach suggests the final legislation will balance regulatory needs with practical business considerations.

In an industry where profit motives must be balanced with compassionate care for the dying, this legislation represents a thoughtful step toward ensuring that end-of-life care remains focused on patients and families while still allowing ethical businesses to thrive.

1. Nevada Legislature considers bill to regulate hospice care – Brushwood Media Network

2. https://hospicenews.com/2025/03/05/state-legislators-propose-new-bill-to-combat-hospice-fraud-in-h otbed-region/

3. Freshman Orientation: Dr. Rebecca Edgeworth seeks to improve health care for Nevadans - The Nevada Independent

4. https://cepr.net/publications/preying-on-the-dying-private-equity -gets-rich-in-hospice-care/

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