Hospice CARE Act Looks to Reform Medicare Hospice Benefits

WASHINGTON—Rep. Linda T. Sánchez and Sen. Mark Warner introduced the Hospice Care Accountability, Reform and Enforcement (CARE) Act to modernize the Medicare hospice benefit, protect patients and taxpayers from fraud and expand access to essential services and caregiver support.

Sanchez and Warner said the Hospice CARE Act would strengthen the Medicare hospice benefit through a combination of program integrity provisions and payment reforms to ensure it better meets the needs of terminally ill patients and their families.

“The National Partnership for Healthcare and Hospice Innovation thanks Senator Mark Warner and Congresswoman Linda Sánchez for their continued leadership on improving the experience for patients and families at the end-of-life, including with today’s introduction of the Hospice CARE Act of 2026,” said Tom Koutsoumpas, founder and CEO of NPHI. “This legislation provides an important opportunity to pursue thoughtful reforms to the Medicare hospice benefit that both preserve patient access and address ongoing concerns related to program integrity. 

“While the bill represents meaningful progress toward modernizing the benefit and reducing incentives for fraud, waste and abuse, NPHI believes certain provisions—particularly those related to payment reform—present opportunities for further discussion and refinement,” Koutsoumpas continued. “We look forward to working closely with Senator Warner, Representative Sánchez, the Senate Finance Committee and the House Ways and Means Committee to ensure the legislation delivers thoughtful reforms that strengthen the hospice benefit for mission-driven providers and the patients they serve.”

The bill creates additional safeguards to prevent fraudulent providers from enrolling in Medicare and increases oversight of hospices, especially new hospices. 

• Temporarily prevents new hospices from enrolling in Medicare, while allowing exceptions for instances where additional access to care is needed.
• Requires increased transparency of hospice ownership and managing control information, ensuring the Centers for Medicare & Medicaid Services’ (CMS) enrollment records are up to date.
• Increases survey frequency for new hospices to ensure they meet hospice health and safety standards and prohibits payments to hospices that do not submit required quality data to the Secretary, with appropriate exceptions.
• Reduces the potential for inappropriate financial conflicts of interest when certifying individuals’ eligibility for hospice care, while allowing nurse practitioners and physician assistants to also certify eligibility.
• Requires CMS to conduct additional oversight activities to ensure hospices are providing holistic and comprehensive care.
• Provides patients with an explanation of benefits within 15 days of an individual’s hospice election to increase beneficiary awareness of hospice enrollment and prevent extended periods of fraudulent billing.

“Hospice should provide comfort and dignity at the end of life, yet the benefit has not evolved to meet families where there is need,” said Sánchez. “This bill strengthens and enhances Medicare’s hospice benefit so it provides the critical care patients and their families need—like respite care for caregivers and coverage of palliative treatments like dialysis and radiation—all while protecting the program from those trying to exploit it.”