Sponsors (5)
I'll give you the short version of this bill.
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
Adds a new Community-Based Palliative Care Model under section 1115A of the Social Security Act that directs the Center for Medicare & Medicaid Innovation (CMMI) to develop and run a five-year demonstration. The model will deliver team-based palliative care and care coordination for high-risk Medicare Part A beneficiaries, provide flexible site options (including in-home and community settings), require 24/7 access (including telehealth), and measure participant outcomes against similar beneficiaries outside the model. The model is intended to succeed the Medicare Care Choices Model and must begin within one year of enactment.
Adds language to subsection (b)(2)(A) of Section 1115A to require that the models selected include testing of the model described in the new subsection (h).
Creates a new subsection (h) directing the CMI to develop and implement a Community-Based Palliative Care Model to provide palliative care and care coordination for high-risk beneficiaries, in co-management with other providers, aimed at improving outcomes and reducing unnecessary emergency department visits and hospitalizations. The model is intended to replace the Medicare Care Choices Model.
The model shall be implemented for a 5-year period, beginning not later than one year after the date of the enactment of this subsection.
Defines the target population as individuals entitled to or enrolled for benefits under Medicare Part A who have a diagnosis of a serious illness or injury. The statute lists example diagnoses including cancer; heart and vascular disease; pulmonary disease; HIV/AIDS; Alzheimer's and dementia; stroke; serious injury requiring rehabilitation (including burns); kidney disease; liver disease; Amyotrophic lateral sclerosis; any neurodegenerative disease; or any other serious illness or injury the Secretary determines appropriate.
An individual shall not be excluded from participation in the model based on prior use of hospice care benefits during any period prior to such participation, regardless of the source of coverage for such benefits.
Primary beneficiaries are high-risk Medicare Part A enrollees who may gain earlier and more continuous access to palliative care in community or home settings with 24/7 support and telehealth options. Community-based providers—home- and community-health teams, hospice and palliative care clinicians, care coordinators, and multidisciplinary teams—are likely to be recruited into the demonstration and may face new reporting and operational requirements (scheduling for 24/7 coverage, telehealth infrastructure, data collection). Hospitals and inpatient providers could see reduced avoidable admissions or shorter stays if the model reduces acute utilization, but effects will depend on model design and payment incentives. CMMI/CMS will incur administrative responsibilities to design, run, and evaluate the model; the statutory text does not specify new appropriations or permanent Medicare coverage changes, so any longer-term expansion would depend on evaluation results and future rulemaking or legislation. Caregivers and families may benefit from improved care coordination and around‑the‑clock access, but providers may need technical assistance and transitional funding to meet 24/7 and measurement requirements. Data-collection and comparison-group requirements may increase administrative and compliance workload for participating providers.
Expand sections to see detailed analysis
Read twice and referred to the Committee on Finance.
Introduced June 3, 2025 by Jacklyn Sheryl Rosen · Last progress June 3, 2025
Read twice and referred to the Committee on Finance.
Introduced in Senate