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.
“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.”
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.
“Making decisions about hospice and end-of-life care is one of the most difficult moments that families can endure, yet Medicare’s hospice benefit is out of touch with the needs of patients and providers,” said Warner. “I’m proud to introduce this legislation that will prioritize patient comfort at home as well as in a health care facility and protect patients and taxpayers from bad actors attempting to steal essential resources.”