Hospice CARE Act of 2026

Improved Access in Underserved Areas (Section 2, Section 1866(j)(10)(B) of the Social Security Act): The bill allows the Secretary to exempt new hospice programs from the nationwide enrollment moratorium if they furnish care in areas with insufficient access, wait times, or evidence of unmet needs. This ensures that individuals living in underserved regions can still access necessary end-of-life care.

Enhanced Transparency on Ownership (Section 2, Section 1866(j)(10)(E) of the Social Security Act): The Secretary is required to publish ownership interest and managing control information for all enrolled hospice programs on a public website. This gives patients and their families clearer insight into who owns and operates the hospice facilities caring for their loved ones.

Expanded Certification Providers (Section 2, Section 1814(a)(7)(A)(i)(I) of the Social Security Act): The bill allows nurse practitioners and physician assistants to certify terminal illnesses starting October 1, 2027. This change can streamline the process for patients getting certified for hospice care when traditional physicians are unavailable.

Clearer Billing and Benefits Information (Section 2, Section 1806(d) of the Social Security Act): Individuals who elect hospice care will receive a notice within 15 days detailing their coverage, program contact information, and instructions on reporting Medicare waste, fraud, and abuse. This empowers patients and families to monitor their care and protect against fraudulent billing.

New In-Home Respite Care Options (Section 3, Section 1861(dd)(1)(I) of the Social Security Act): Starting October 1, 2029, the bill introduces short-term home respite care furnished directly in a patient's home residence on an intermittent basis. This provides additional support for families caring for terminal patients at home.

Restricted Options from Enrollment Moratorium (Section 2, Section 1866(j)(10)(A) of the Social Security Act): The legislation imposes a mandatory five-year nationwide temporary moratorium on enrolling new hospice programs. Individuals living in areas that do not meet strict exemption criteria may face a lack of new local provider choices.

Stricter Prepayment Reviews and Potential Delays (Section 2, Section 1814(a)(7)(F) and Section 1812(d)(2)(E) of the Social Security Act): Hospice care provided for more than 90 days by programs with aberrant billing patterns, as well as non-terminal items and services billed as unrelated to the terminal condition, will be subject to prepayment medical review. This mandatory review process could potentially result in delayed payments or administrative burdens that affect patient care delivery.

Mandatory Face-to-Face Encounters (Section 2, Section 1814(a)(7)(F) of the Social Security Act): Hospice physicians, nurse practitioners, or physician assistants must conduct a face-to-face encounter not more than 30 days before each recertification. While intended to verify ongoing eligibility, this strict mandate creates logistical requirements that patients and providers must continually meet to maintain benefits.