# 119-s-4118: Hospice CARE Act of 2026 119-s-4118, Hospice CARE Act of 2026, is a 119th Congress bill sponsored by Sen. Warner, Mark R. [D-VA] (D-VA); status introduced; PRIA reads it as touching household money (as of 2026-04-22). - Canonical: https://policyrisk.com/legislation/119-s-4118 - As of: 2026-04-22 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: 119-s-4118 - Congress: 119 - Title: Hospice CARE Act of 2026 - Status: introduced - Introduced: 2026-03-17 - Sponsor: Sen. Warner, Mark R. [D-VA] (D-VA) - Cosponsors: 0 - Policy area: unknown - Touches household money: yes - Last recorded action: 2026-04-22 ## Summary **A nationwide five-year moratorium on new hospice enrollments** would pause new hospice program starts while forcing tighter ownership transparency, stricter clinician and governance rules, and a major rewrite of hospice payment rates to curb abuse and better align payments with costs. - Patients and families: Would require a detailed Medicare notice within 15 days after a hospice election, add mandatory face-to-face recertification visits, and create a short-term home respite benefit of up to 120 hours in any 90-day period. - Hospice programs and clinicians: Would freeze new enrollments for five years, expand ownership and control reporting and penalties, tighten credentialing and medical director rules, and generally limit a medical director to one other hospice program (effective January 1, 2029). - Medicare payments and oversight: Would overhaul rate-setting, pay 400 percent of certain routine home care amounts for specified palliative services during Oct 1, 2027–Sept 30, 2032, add an outlier payment program with a 5 percent annual cap, and require audits, technical panels, and expanded surveys to inform caps and rates. *Authorizes transfers of at least $40.0 million from the Federal Hospital Insurance Trust Fund to CMS accounts for notices, audits, and oversight, and would increase federal outlays for those activities.* ## Provisions PRIA read - Broader hospice certifying clinician rules: benefit, medium. If enacted, nurse practitioners and physician assistants would be allowed to certify terminal illness for hospice elections on or after October 1, 2027. The bill would require a face-to-face clinical encounter by a hospice physician, nurse practitioner, or physician assistant within 30 days before… - Hospice election notices and discharge info: benefit, low. If enacted, hospice elections made on or after October 1, 2027 would need an addendum listing services not related to the terminal illness and be updated if things change. The Secretary would have to send a written notice within 15 days after elections made one year after enactment, showing the eff… - New short-term home respite rules: benefit, low. If enacted, the bill would create a short-term home respite benefit starting October 1, 2029. Respite would be limited to no more than 120 hours in any 90-day period (or 80 hours in any 60-day period) and must be intermittent and nonroutine. For fiscal year 2030 and later, respite pay would equal t… - Limits on hospice aide coverage: cost, medium. If enacted, the bill would remove home health aide and homemaker services from the hospice benefit for people who live at home starting October 1, 2029. For people in skilled nursing or nursing facilities, homemaker services would be excluded except when provided by volunteers as allowed today. Thi… - Major Medicare hospice payment overhaul: mixed, high. If enacted, the bill would change how Medicare pays hospices and how the yearly hospice cap is set. For some fiscal years the cap would first be adjusted by the bill's estimated payment change and then increased by the market basket, and from fiscal year 2036 the cap would be increased only by the… - Moratorium and payment bans for hospices: mixed, medium. If enacted, the bill would place a nationwide 5-year moratorium on new Medicare hospice enrollments starting on the date of enactment, with Secretary exemptions for areas with insufficient access. The Secretary would require revalidation of existing enrollments in the first 6 months and publish own… - New hospice audits and reviews: mixed, medium. If enacted, the bill would require special training for anyone who does medical review of hospice claims for reviews done on or after January 1, 2028 and would require a public report to Congress by October 1, 2028 on review accuracy, denials, appeals, and audit work. The Secretary would audit repr… ## Related bills - 119-s-3990: PrEP Access and Coverage Act of 2026 - 119-s-2763: Keep Billionaires Out of Social Security Act - 119-s-51: Washington, D.C. Admission Act - 119-s-5108: Right to IVF Act of 2026 - 119-s-2982: Federal Employees Civil Relief Act - 119-s-1503: Equality Act ## Sources - [119-s-4118 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/4118) ## Related - [119-s-3990: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-s-3990) - [119-s-2763: Keep Billionaires Out of Social Security Act](https://policyrisk.com/legislation/119-s-2763) - [119-s-51: Washington, D.C. Admission Act](https://policyrisk.com/legislation/119-s-51) - [119-s-5108: Right to IVF Act of 2026](https://policyrisk.com/legislation/119-s-5108) - [119-s-2982: Federal Employees Civil Relief Act](https://policyrisk.com/legislation/119-s-2982) - [119-s-1503: Equality Act](https://policyrisk.com/legislation/119-s-1503) - [All bills in Congress](https://policyrisk.com/legislation) Source: PRIA, https://policyrisk.com/legislation/119-s-4118 (as of 2026-04-22).