Medicare Eyes 2027 Hospice Wage Updates and New Reporting Rules
Published Date: 4/6/2026
Proposed Rule
Summary
Starting in Fiscal Year 2027, Medicare is updating how much it pays hospices and adjusting the wage index that helps set those payments. Hospices will also need to give patients a new form when they start care, and there are some changes to quality reporting rules. These updates affect hospices nationwide and aim to improve care while keeping payments fair—comments on the proposal are open until June 1, 2026.
Analyzed Economic Effects
7 provisions identified: 3 benefits, 1 costs, 3 mixed.
FY2027 Hospice Payment Update (2.4%)
CMS proposes a hospice payment update percentage of 2.4 percent for FY 2027 (inpatient hospital market basket 3.2% minus a 0.8 percentage point productivity adjustment). CMS estimates the overall economic impact as $785 million in increased payments to hospices in FY 2027.
Hospice Wage Index Updated for FY2027
For FY 2027, the hospice wage index would be recalculated using FY 2023 hospital wage data and continue to include the hospice floor (a 15% increase up to 0.8000) and the permanent 5% cap on any annual wage index decrease. The proposal lists specific proposed wage index values for certain areas, for example: Hinesville, GA 0.8917; rural North Dakota 0.8299; and rural Puerto Rico proposed value 0.3990.
Telehealth Face-to-Face Extension to Dec 31, 2027
CMS proposes to extend the telehealth allowance for the hospice recertification face-to-face encounter until December 31, 2027, require inclusion of modifiers or codes for such encounters, and prohibit telehealth face-to-face encounters in specific situations related to moratoriums, enhanced oversight, or enrollment status.
Hospice Quality Reporting Penalty (-1.6% Proposed)
Hospices that do not submit required Hospice Quality Reporting Program (HQRP) data would face a proposed reduction in their FY 2027 payment update; instead of the 2.4% update, non-submitting hospices would receive -1.6% (2.4% minus 4 percentage points) applied to payment rates.
Mandatory Hospice Election Addendum
CMS proposes to require hospices to give the hospice election statement addendum to all Medicare beneficiaries at the time they elect hospice care. This would make the addendum mandatory for every hospice election under Medicare.
Who May Discharge Hospice Patients Expanded
The rule proposes a conforming regulatory change to allow a physician designee or a physician member of the hospice interdisciplinary group, in addition to the hospice medical director, to discharge a patient from hospice care, aligning Conditions of Participation and payment regulations.
HQRP Public Reporting: Care Compare Icon Added
CMS proposes updates to the Hospice Quality Reporting Program that include adding an icon to the Medicare.gov Care Compare tool and changes to public reporting timeframes and future measures so beneficiaries can more easily find hospice quality information online.
Your PRIA Score
Personalized for You
How does this regulation affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this federal register document and every other regulation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-07205 — Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges
Starting soon, Medicare Advantage, Medicaid, CHIP, and health plans on federal exchanges will need to use better tech to share health info and speed up drug approval requests. This means less waiting and smoother care for patients, while plans and agencies will update their systems to meet new rules. These changes aim to save time and money by making health data work together more easily, with deadlines coming in the next couple of years.
2026-06600 — Medicare Program; Contract Year 2027 and Certain Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program
Starting January 1, 2027, Medicare Advantage, Prescription Drug, and Cost Plan programs are getting some fresh updates! These changes improve how plans are rated, marketed, and how drugs are covered, making it easier and better for millions of Medicare users. The new rules kick in June 1, 2026, so plans can get ready to serve you smarter and smoother next year.
2026-04797 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some typos and technical mistakes in the big Medicare and Medicaid payment rules for 2026. It affects doctors, healthcare providers, and anyone using Medicare Part B by making sure payment and coverage details are clear and correct starting January 1, 2026. These corrections help keep payments fair and accurate without changing the original money amounts or deadlines.
2026-04467 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some missing labels in important tables from the 2027 health insurance rules under the Affordable Care Act. It mainly affects insurance companies and people using marketplace plans by clarifying how risk and payments are calculated. These fixes take effect right away on March 6, 2026, ensuring everyone has clear info for next year's coverage and costs.
2025-23081 — Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction
This correction fixes some math and typo mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2025. It mainly affects rehab centers by updating their payment rates and quality reporting details to be fair and accurate. These changes ensure providers get the right money and info for the 2026 fiscal year.
2025-22543 — Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
Medicare is updating its payment plans to help more people get organ transplants through the Increasing Organ Transplant Access (IOTA) Model starting in Performance Year 2. These changes affect hospitals and doctors who work with Medicare patients needing transplants, aiming to improve care and save lives. Comments on the proposed rule are open until February 9, 2026, so stakeholders can share their thoughts before it’s finalized.
Previous / Next Documents
Previous: 2026-06578 — Walking-Working Surfaces
OSHA is proposing to remove the deadline that requires all fixed ladders over 24 feet to have personal fall arrest or ladder safety systems. They’re also asking if employers should be allowed to keep using ladder cages instead of these newer safety systems. This affects employers with tall ladders and could change safety rules, with comments due by June 5, 2026.
Next: 2026-06605 — Airworthiness Directives; Pilatus Aircraft Ltd. Airplanes
Pilatus airplane owners and operators, listen up! The FAA wants to update safety rules for several PC-6 models by adding stricter maintenance checks and inspections to keep flights safe. Comments are open until May 21, 2026, so get ready to review and possibly spend a bit on extra inspections to keep your aircraft flying strong.