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If enacted, the legislation would be the single most significant update to the hospice benefit and payment structure since its inception in 1982

WASHINGTON, D.C., SEPTEMBER 26, 2024 – Today, Congressman Earl Blumenauer (D-OR), a senior member of the Ways and Means Committee, introduced the Hospice Care Accountability, Reform and Enforcement Act (Hospice CARE Act) to modernize Medicare’s hospice benefit, which has remained largely unchanged since its inception in 1982. The proposal comes as egregious reports of fraud and abuse within the benefit persist, despite action from Centers for Medicare & Medicaid Services (CMS). The legislation is the product of years of collaboration between stakeholders, lawmakers, and industry leaders. It builds on Blumenauer’s decades-long commitment to ensure the federal government supports families at a time of great stress and vulnerability: the end of life. 

“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,” said Congressman Earl Blumenauer. “Patients and families deserve better. We need a reset. It is past time for Congress to act to end the fraud, waste, and abuse within the hospice benefit and bring it into the 21^st century.”

To protect patients and taxpayers, the Hospice CARE Act would institute a number of long overdue reforms to crackdown on fraud while incentivizing high-quality care. Critically, it would:

• • Reform the payment structure: The underlying hospice per-diem payment structure—which generally pays hospices for each day of care regardless of if care is provided on a given day—rewards bad actors who exploit the benefit for financial gain. The legislation revises the payment structure to ensure that providers are incentivized to deliver high-quality care and meet the current needs of individuals and their families.
  • Bolster program integrity: Additional safeguards and oversight is needed to prevent fraudulent providers from enrolling in Medicare, especially for new hospices. That includes temporarily preventing new hospices from enrolling in Medicare, with exceptions where additional access to care is needed, increasing survey frequency, and increasing ownership transparency

A one-page fact sheet can be found here. Bill text here. 

“The hospice benefit, while unique, is ripe for change. This legislation is a first-of-its-kind opportunity to improve it,” said Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit providers of aging services, including hospice, on the Hospice Care Accountability, Reform and Enforcement (CARE) Act of 2024. “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.  There is more work to do and we look forward to continuing our productive partnership to ensure this bill achieves these goals.” 

 “The National Partnership for Healthcare and Hospice Innovation (NPHI) is thankful for the work of Congressman Blumenauer, his staff, and the Ways and Means Committee staff who worked with the hospice and advanced illness community to put forward the Hospice Care Accountability, Reform, and Enforcement (CARE) Act. 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 non-profit providers who were the original foundation of hospice care,” said Tom Koutsoumpas, CEO and founder of NPHI. “We look forward to continuing to work closely with Congress and relevant stakeholders on efforts to modernize the hospice benefit and improve care of those at the end-of-life.

“The Coalition to Transform Advanced Care (C-TAC), truly appreciates the introduction of the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. We commend Representative Earl Blumenauer (D-OR-3rd) for this important work and for his decades of support for compassionate end-of-life care and for bringing policies to the national stage with bi-partisan support,” stated Jon Broyles, C-TAC CEO.  “We have had the privilege to work with the Congressman, his staff, Ways & Means Committee staff and other advocates on this bill and it is an important starting point for ideas that will lead to modernizing the hospice program and improving the lives of people with serious illness and their family caregivers.”

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This press release was issued by the office of U.S. Congressman Earl Blumenauer, representing the 3rd district of Oregon. The original press release can be found here. The Rowan Report has reached out to The Alliance for Care at Home for comment.