Hospice CARE Act of 2024

This bill amends the Social Security Act to reform hospice care under Medicare, focusing on integrity, oversight, and payment changes. It imposes a temporary moratorium on new hospice enrollment, increases survey frequency for certain programs, and adjusts payment rates for hospice services.

Sec. 2, Ensuring the integrity of hospice care: The bill imposes a nationwide 5-year moratorium on enrolling new hospice programs, with exemptions for areas lacking access. It requires prepayment medical review for certain hospices with aberrant claims, revalidates enrollment info within 6 months, and publishes ownership data. It extends enhanced oversight for newly enrolled hospices to up to 2 years, mandates surveys every 18 months for new or outlier hospices, and prohibits payment to hospices failing quality data reporting from 2027 onward. It also requires physician certifications of terminal illness to be independent, with rules for when a patient lacks an attending physician.

Sec. 3, Payment reforms for hospice care: The bill adjusts payment rates for hospice care, specifying percentages to align rates with costs for non-routine home care starting in fiscal year 2029, and for routine home care from 2033. It introduces a per diem and per visit payment structure for routine home care from 2029, with a 400% payment for specified hospice care (e.g., palliative chemo, radiation, transfusions, dialysis) from 2026 to 2031. It allows outlier payments for routine home care from 2031, capped at 5% total and 10% per hospice. It requires plans of care for specified hospice care to be established by an independent oncologist or nephrologist, and excludes home health aide and homemaker services from hospice care for individuals not in skilled nursing or nursing facilities.