Hospice CARE Act of 2026

Key Points

• The bill imposes a 5-year nationwide freeze on new hospice programs enrolling in Medicare, with exceptions only for areas where patients lack adequate access to end-of-life care. This aims to stop bad actors from opening hospice companies solely to profit from fraud.
• Medicare payment for hospice care gets restructured to better reflect actual costs. For the first time, specialized palliative treatments like chemotherapy, radiation, blood transfusions, and dialysis would be paid at 400% of the routine home care rate, so patients don't have to give up those treatments to receive hospice.
• Doctors, nurse practitioners, or physician assistants who certify a patient as terminally ill cannot have financial ties to the hospice company. The bill also newly allows nurse practitioners and physician assistants to make these certifications, making the process faster for families.
• A new home respite care benefit gives family caregivers up to 120 hours of professional help per 90-day period in the patient's own home, so caregivers can rest without moving their loved one to a facility. This benefit starts October 1, 2029.
• Hospice programs with suspicious billing patterns face mandatory prepayment medical review, and all enrolled hospices must revalidate their enrollment information within 6 months. Ownership data, including private equity involvement, will be published and reported to Congress.
• Patients entering hospice will receive a detailed notice within 15 days explaining their rights, the hospice program's contact info, and how to report suspected fraud. Hospice programs must also give patients a written list of services not covered under their hospice election.