Bill · S. 4118· Senate(119-S-4118)
Hospice CARE Act of 2026
- Introduced
- 3/17/2026
- Last activity
- 3/17/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Mark Warner
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
The Hospice CARE Act of 2026 aims to improve the integrity of Medicare-funded hospice care. It establishes a five-year nationwide moratorium on new hospice program enrollments, with certain exemptions for underserved areas. The bill increases oversight through more frequent surveys, stricter ownership reporting, and mandatory prepayment medical reviews for programs with aberrant billing. It also updates payment structures, expands who can certify terminal illness, and adds new respite care options. Additionally, it requires hospitals to provide better discharge planning regarding available hospice services.
Yes· 3 of 18
Would retired people be better off under this?+8
Directly improves the quality, integrity, and available options for end-of-life care under Medicare.
Would people over 65 be better off under this?+7
Provides better integrity, transparency, and expanded respite care options for elderly patients in hospice.
Does this make what the government does easier for the public to see?+7
Requires public website publication of hospice ownership and managing control information.
The opposite· 3 of 4
Would business owners be better off under this?-5
Hospice business owners face stricter reporting, higher penalties, and enrollment restrictions.
Does this make it easier to run a small business?-4
New enrollment restrictions and high penalties for ownership changes may disproportionately burden small hospice providers.
Does this leave more decisions to the states?-3
Federal mandates on enrollment and oversight may override state-level hospice management preferences.
Who it would affect, and how
Potential Positive Impacts for People
- Increased Access in Underserved Areas: The Secretary can exempt new hospice programs from the enrollment moratorium if they serve areas with insufficient access or unmet needs (Section 2(a)(1)(10)(B)).
- Patient Transparency: Individuals making a hospice election will receive a notice within 15 days specifying their provider, the certifying clinician, and how to report waste, fraud, and abuse (Section 2(l)(1)).
- Expanded Certification Options: Starting October 1, 2027, physician assistants and nurse practitioners can certify terminal illnesses, potentially increasing the number of available providers (Section 2(f)(1)).
- Improved Independence of Care: To ensure integrity, certifications for terminal illness must be made by a provider without a significant financial relationship or ownership interest in the hospice program if the attending physician is employed by that program (Section 2(e)(1)).
- Enhanced Respite Care: The bill allows respite care to be provided in certain residential care facilities (Section 3(c)(2)) and introduces payment for short-term home respite care (Section 3(e)(1)).
- Better Hospital Transitions: Hospitals must now inform patients eligible for hospice care about the availability of such care and respite services in their area during discharge planning (Section 3(d)(1)(E)).
Potential Negative Impacts for People
- Limited Provider Growth: The mandatory five-year nationwide moratorium on new hospice enrollments could limit the overall growth of available hospice programs (Section 2(a)(1)(10)(A)).
- Payment Denials for Data Failure: Starting in fiscal year 2028, no payments will be made to hospice programs that fail to submit required data to the Secretary, which could threaten the financial stability of those programs (Section 2(d)(1)(C)).
- Stricter Recertification Requirements: Starting October 1, 2027, a face-to-face encounter is required no more than 30 days before each recertification to determine continued eligibility for care (Section 2(n)).
- Financial Penalties for Ownership Changes: Hospice programs that fail to provide advance notice of changes in ownership or control can face civil monetary penalties up to $1,000,000 or termination of enrollment (Section 2(i)(2)(A)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+8Good For Seniors+7Good For Low Income Households+4Good For Middle Class Households+4Good For Rural Residents+3Good For African Americans+2Good For Asian Americans+2Good For Hispanic Americans+2Good For Native Americans+2Good For White Americans+2Good For Business Owners-5
- Governance And Ideology
- Improves Government Transparency+7Increases Federal Power+5Increase States Rights-3
- Economy And Finance
- Improves Consumer Protection+6Improves Fiscal Responsibility+5Reduces National Debt+2Improves Small Business Support-4Increases Job Creation-3
- Healthcare
- Improves Healthcare Access+4Increases Medicare Funding+2
- Environment Energy And Infrastructure
- Improves Rural Development+2
- 3/17/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.