What changed for caregivers this week — October 19, 2026

Abby Care raises $82 million to train and pay family caregivers, Dartmouth Health launches a $20 million in-home primary and palliative care program, Homestead Hospice settles a $1.93 million fraud lawsuit, and CMS enrollment moratoria are quietly reshaping which home health and hospice providers can serve new patients — a week where money moved in ways that will eventually reach families at home.

Abby Care just raised $82 million to train and pay family members as home care workers — and the model is worth understanding before assuming it applies everywhere

San Francisco-based Abby Care has closed an $82 million Series C round, according to Home Health Care News. The company trains family members — adult children, spouses, siblings — to provide home care for a relative with complex needs and then pays them as formal caregivers through Medicaid's consumer-directed care programs. The funding will go toward expanding into new states and building out the training infrastructure the model depends on.

The concept is not new — consumer-directed Medicaid programs that allow family members to be paid as caregivers have existed in various forms for decades — but Abby Care is trying to systematize the training and administrative side that most state programs leave families to figure out on their own. For a family member who is already providing full-time care for a parent or spouse and losing income to do it, this model can make a material difference. The catch is that eligibility depends entirely on the state: not every Medicaid program allows family members to be paid caregivers, and those that do have different rules about which relatives qualify, what training is required, and how much the pay rate is. The best starting point is the state Medicaid office or a local Center for Independent Living, which can confirm whether a consumer-directed option exists and what the enrollment process looks like. Abby Care's own website lists the states where it currently operates. A family that has been providing unpaid care for months without knowing this option existed is not unusual — the programs are real but chronically underadvertised.

Dartmouth Health is launching a $20 million in-home primary and palliative care program — and it is specifically designed for the rural and remote families most likely to have no other option

Dartmouth Health and the Geisel School of Medicine at Dartmouth are standing up a new program called Dartmouth Health at Home, backed by a $20 million philanthropic gift, according to Home Health Care News. The program will deliver primary care and palliative care directly in patients' homes, with an explicit focus on rural and underserved communities in New England where those services are either absent or require travel that is not realistic for someone who is seriously ill or functionally limited.

Hospice News reported separately that Dartmouth Health is also addressing rural hospice and palliative care disparities as part of the same initiative, noting that end-of-life care gaps in rural areas are driven by a shortage of clinicians willing to travel and a reimbursement structure that does not account for the time and distance involved. For families in rural New England, this program is worth watching — it is not yet operational at scale, but Dartmouth Health's existing network covers a wide geography across New Hampshire, Vermont, and surrounding areas. More broadly, this initiative is a reminder that palliative care does not require a hospital or a specialist office. For any family managing a parent with serious illness at home — regardless of geography — the Center to Advance Palliative Care at capc.org maintains a searchable directory of palliative care programs by location, including those that offer home-based services.

Homestead Hospice has settled a $1.93 million fraud lawsuit — and families should know what a qui tam case actually signals about a provider

Georgia-based Homestead Hospice has reached a $1.93 million settlement in a False Claims Act case brought under the qui tam provision, meaning the lawsuit was originally filed by a whistleblower — typically a current or former employee — rather than initiated by the government, according to Hospice News. The settlement does not constitute an admission of wrongdoing, but the company agreed to pay the amount to resolve allegations of improper billing under Medicare.

For families, the practical significance of a qui tam settlement is what it suggests about internal oversight at a provider. Whistleblower cases in hospice typically involve billing for patients who did not meet the eligibility criteria for the hospice benefit — meaning they were not certified as having a terminal prognosis of six months or less — or billing for services that were not delivered at the documented level. Either pattern can affect the quality of care a patient actually receives, because a hospice that is enrolling ineligible patients or inflating visit records is not organizing its operations around genuine clinical need. Homestead Hospice operates primarily in Georgia. Families who want to check the complaint and enforcement history of any Medicare-certified hospice can use the Medicare Care Compare tool at medicare.gov, which includes quality ratings and inspection data. A settlement of this size, in a sector where the median hospice serves a relatively small patient census, is not a minor administrative matter.

CMS enrollment moratoria on home health and hospice are limiting which providers can take new Medicare patients — and families trying to arrange care right now may run into this without warning

Since May, CMS has had temporary enrollment moratoria in place for new home health and hospice providers seeking to enroll in Medicare in certain high-fraud-risk areas, according to coverage in both Home Health Care News and Hospice News. The moratoria do not affect providers already enrolled in Medicare — they block new providers from entering the program in designated counties and metropolitan areas. The affected geographies include parts of Texas, Florida, Michigan, and other states with historically elevated fraud rates in these benefit categories.

The immediate effect on families is indirect but real. A moratorium on new provider enrollment means that in affected areas, the supply of Medicare-certified home health and hospice providers is frozen — no new agencies can enter the market to serve patients while the moratorium holds. For a family in one of those areas trying to arrange home health care after a hospitalization, or looking for a hospice provider with availability, the pool of options is smaller than it would otherwise be, and agencies that are already enrolled may have longer wait times or limited capacity. The practical step is to ask the hospital discharge planner or the patient's physician which Medicare-certified agencies are currently accepting new patients in the specific zip code — not which agencies exist, but which ones have capacity. Medicare Care Compare at medicare.gov allows families to search for home health and hospice providers by location and review quality data before making a choice.

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