Hospice rules clarified: Medicare fine-tunes end-of-life payments
Published Date: 4/30/2025
Proposed Rule
Summary
Starting in Fiscal Year 2026, hospices will see updated payment rates and wage indexes that could affect how much money they get. New rules will also change how patients get admitted to hospice and update quality reporting requirements to keep care top-notch. These changes aim to make hospice care better and fairer, so providers and patients both win!
Analyzed Economic Effects
6 provisions identified: 0 benefits, 0 costs, 6 mixed.
Hospice Wage Index Updated for FY2026
Starting in Fiscal Year 2026, the hospice wage index used to adjust Medicare payments to hospices will be updated. This change alters how Medicare adjusts payments across geographic areas for hospice staffing and wages in FY2026.
Hospice Payment Rates Changed for FY2026
This proposed rule updates hospice payment rates for Fiscal Year 2026. The updated payment rates will determine how much Medicare pays hospices for services during FY2026.
Aggregate Cap Amount Adjusted for FY2026
The proposed rule updates the hospice aggregate cap amount for Fiscal Year 2026. The aggregate cap limits total Medicare payments to a hospice provider and the update will apply in FY2026.
Changes to Hospice Admission Rules
The rule proposes changes to the regulations for admission to hospice beginning in Fiscal Year 2026. These admission regulation changes affect how patients are admitted to hospice care under Medicare rules in FY2026.
Face-to-Face Attestation Requirement Revised
The proposed rule would change the hospice face-to-face attestation requirements under the certification of terminal illness regulations for FY2026. This affects clinicians and the documentation needed to certify patients as terminally ill for hospice enrollment.
Updates and RFI on Hospice Quality Reporting
The proposed rule provides updates to the Hospice Quality Reporting Program (HQRP) requirements and solicits comments on future measure concepts for the HQRP. These changes and the request for information affect hospice providers who report quality data and stakeholders invited to comment.
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