Medicare hospice bill freezes new providers and overhauls payment rules

What does this do?

HR 7966 imposes a five-year freeze on new hospice companies joining Medicare, with exceptions for underserved areas, and requires all existing hospice programs to re-verify their enrollment information. The bill also restructures Medicare hospice payments, moving away from a flat daily rate toward a system that pays per visit for direct care such as nursing or therapy. Starting in 2028, hospice companies must give Medicare 90 days advance notice before changing ownership.

Who does it affect?

Medicare patients nearing the end of life and their families are directly affected, as are hospice companies and the doctors and nurses who work in hospice care. Doctors with financial ties to a hospice company will no longer be permitted to certify that a patient is terminally ill.

Why does it matter?

The payment restructuring and enrollment freeze alter the financial and regulatory conditions under which hospice providers operate within Medicare. Patients who enroll in hospice will receive written notice of their benefits and fraud-reporting contacts, and inspections of newer or suspicious programs will become more frequent.

Where does it stand?