Legislation Would Overhaul Medicare Hospice Benefit
HR 9803, Congressman Earl Blumenauer’s Hospice CARE Act legislation, updates hospice benefits & payment structures
By Juliana Frederick
Rep. Earl Blumenauer (D-OR), a senior member of the Ways and Means Committee, introduced HR 9803, the Hospice Care Accountability, Reform and Enforcement Act (Hospice CARE Act) in an effort to modernize Medicare’s hospice benefit, which has remained largely unchanged since its 1982 inception.
The Hospice CARE Act would institute several reforms to limit fraud, incentivize quality care and protect patients and taxpayers. If passed, the legislation would:
- Reform the payment structure. The underlying hospice payment structure—which generally pays hospices for each day of care, regardless of whether care is provided on a given day—rewards those who exploit the benefit for financial gain. The legislation would revise the payment structure, ensuring that providers are incentivized to deliver high-quality care and meet the needs of individuals and their families.
- Bolster program integrity. Additional safeguards would be introduced to prevent fraudulent providers from enrolling in Medicare, especially new hospices. This would include temporarily preventing new hospices from enrolling in Medicare—with exceptions where additional access to care is needed—increasing survey frequency and increasing ownership transparency.
The proposal comes amid reports of fraud and abuse within the benefit, despite action from the Centers for Medicare & Medicaid Services (CMS). The Hospice CARE Act is the result of collaboration between stakeholders, lawmakers and industry leaders seeking to ensure the federal government provides support to families at the end of life.
Voices of Support
“The United States spends significantly more on health care than other developed nations for worse outcomes. Nowhere is this more egregious than in the hospice industry. Patients and families deserve better. We need a reset.” — Rep. Earl Blumenauer
“As a long-standing champion of hospice care, Rep. Blumenauer has consistently demonstrated a commitment to ensuring that hospice services remain accessible, compassionate and of the highest quality for patients and their families. The Alliance appreciates Rep. Blumenauer’s commitment to involving a diverse group of stakeholders in developing this legislation and will continue to work closely with congressional leaders on the finer points of the proposed bill to ensure that the final legislation supports the needs of patients, families and providers alike.” — National Alliance for Care at Home
“The hospice benefit, while unique, is ripe for change. This legislation is a first-of-its-kind opportunity to improve it. Revising a benefit that has not been altered significantly since its creation in 1982 is a formidable undertaking—but a necessary one. Done right, changes will expand the benefit to support the realities of modern-day hospice care and address vulnerabilities that are currently being exploited.” — Katie Smith Sloan, president and CEO of LeadingAge
“This legislation is an encouraging and unique opportunity to consider reforms that would strengthen the Medicare hospice benefit by ensuring it continues to support patients, families and the nonprofit providers who were the original foundation of hospice care.”
— Tom Koutsoumpas, founder and CEO of the National Partnership for Healthcare and Hospice Innovation
