Volume 26.05
The Hospice Care Accountability, Reform, and Enforcement Act (“Hospice Care Act”) has been reintroduced.
The Hospice Care Act contains numerous program integrity provisions and payment reforms. It would establish new safeguards to prevent fraudulent providers from enrolling in Medicare and bolster federal oversight of hospices. It would also make several changes to the existing payment structures.
The Hospice Care Act was originally created and introduced in 2024 by Rep. Earl Blumenauer.
The legislation would institute a moratorium on Medicare enrollment for new hospices, except for cases in which a community needs greater access to care. It would also implement steps to improve the transparency of hospice ownership and managing control information, as well as ensure that the U.S. Centers for Medicare & Medicaid Services’ (CMS) enrollment records are current.
Additionally, the legislation increases survey frequency for new hospices and eliminates all payments to hospices that fail to submit the required quality data, address potential conflicts of interest with those certifying eligibility, and mandates increased oversight by CMS.
We previously reported on the Hospice Care Act when originally introduced. While there may be some good elements of the proposed legislation, there are also many components which will be problems for existing, quality hospice providers.
We will follow the legislation closely and provide significant information and opinion regarding the legislation in subsequent publications. You can secure a copy of the legislation as introduced in 2024 here.
2027 HOSPICE PROPOSED RULE POSTED
The 2027 Hospice Proposed Rule (“Rule”) has been posted for review and is scheduled for publication in the next few days.
Proposed national rates, subject to wage adjustment, are:
Routine home care (days 1-60) $ 236.56
Routine home care (days 61+) $ 186.53
Continuous home care $ 72 .00/hour
Inpatient respite care $ 546.46
General inpatient care $ 1,232.71
The aggregate payment limitation (“CAP”) is proposed at $36,210.11, which is equal to the 2026 CAP updated by the proposed FY 2027 hospice payment update of 2.4%.
The proposed rule also includes an analysis of Medicare non-hospice spending and proposes to require that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election.
The rule proposes conforming regulation text changes to discharge from hospice care regulations, regulation text changes related to face-to-face encounters, the construction of a hospice specific wage index, and changes to the Hospice Quality Reporting Program.
Additional information will be provided as we review the Rule. The Rule can be reviewed here.