Hospice CARE Act of 2026

Key Points

• The bill imposes a 5-year nationwide freeze on new hospice programs joining Medicare, with exceptions only for areas where patients lack access to care. Every currently enrolled hospice must also revalidate its enrollment information within 6 months, and ownership details must be published online within a year.
• Patients entering hospice will receive an Explanation of Benefits letter within 15 days, listing their hospice program, the certifying doctor, and instructions for reporting suspected fraud. The bill also requires hospice programs to give patients an addendum listing any services not covered by hospice.
• New and flagged hospice programs will be surveyed every 18 months instead of every 3 years, and face-to-face encounters between a hospice provider and patient will be required before each recertification of terminal illness starting October 2027.
• The bill creates a new payment structure for routine home care starting in fiscal year 2030, splitting it into a per diem amount for non-direct care costs and a per visit amount for direct patient care like nursing and therapy. It also adds enhanced payments at 400% of routine rates for palliative chemotherapy, radiation, blood transfusions, and dialysis.
• The government must study hospice ownership trends and the role of private equity, with a report due to Congress by January 1, 2028. Medical directors are limited to overseeing no more than two hospice programs, with waivers available on a case-by-case basis.
• A new home respite care benefit begins October 2029, allowing up to 120 hours of professional help per 90-day period in a patient's home so family caregivers can get a break. Hospitals must also inform eligible patients about available hospice programs during discharge planning.