Sponsors (7)
Official title: To amend title XVIII of the Social Security Act to ensure the integrity of hospice care furnished under the Medicare program, and for other purposes.
Introduced March 17, 2026 by Linda T. Sánchez · Last progress March 17, 2026
The bill tightens oversight and increases targeted payments (including a temporary large boost and a new respite benefit) to improve hospice integrity and support services, but it raises federal costs, adds administrative burden, risks local access disruptions, and creates transitional and privacy trade-offs.
Medicare beneficiaries and taxpayers: stronger oversight (ownership transparency, prepayment review, audits, technical expert panels, and funding to improve hospice cap calculations) aims to reduce fraud and improper payments and improve program integrity.
Hospice programs and people receiving hospice care: temporary large increases to routine home care payments, authority for annual adjustments to non-routine and routine rates, and a new Medicare payment for short-term home respite care will boost revenue and create new paid respite benefits for caregivers.
Medicare beneficiaries: increased quality oversight (more frequent surveys, medical director requirements, face-to-face recertification, and other quality measures) should improve accountability and the quality of hospice care.
Medicare beneficiaries (especially local communities) and prospective hospice operators: temporary moratoria and tighter enrollment rules may reduce availability of new hospice programs, delaying or blocking new locations and limiting local access to care.
Taxpayers and the Medicare trust fund: the large temporary payment increases (e.g., 400% of the FY2027 rate for routine home care for a period) will raise Medicare spending and could increase pressure on the Hospital Insurance Trust Fund and the federal budget.
Hospice providers and CMS: the bill adds substantial new administrative and compliance burdens (more reporting, revalidations, prepayment reviews, audits, wage-adjusted caps, and payment-methodology changes), increasing paperwork, systems costs, and potential payment delays.
Based on analysis of 3 sections of legislative text.
Places temporary nationwide moratoria on new Medicare hospice enrollments and programs, increases targeted enforcement and prepayment reviews, and revises hospice payment rules including temporary higher routine home-care rates.
Imposes a temporary nationwide moratorium on new Medicare hospice enrollments and new hospice locations, with narrow exceptions and a separate 5-year pause on new hospice programs, and strengthens enforcement against fraudulent enrollments. It also applies targeted prepayment review for hospices with aberrant billing and directs HHS to publish regulations and report to Congress on hospice integrity risks. Revises Medicare hospice payment rules by adding new payment authorities and temporary higher payment rates for certain routine home hospice care during a defined period, and by changing internal statutory cross-references that narrow and reorganize which payment rules apply to which providers and services. Some payment changes phase in on future fiscal years (including provisions starting Oct 1, 2027, 2030, 2034 and later).