Medicare extends hospice telehealth—but blocks it in problem areas
H.R. 1720 — Hospice Recertification Flexibility Act · Filed by Carol Miller (R-WV) · 5 cosponsors · Introduced Feb 27, 2025 · Referred to committee
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What it does
This bill extends Medicare's telehealth flexibilities for hospice recertifications from March 31, 2025 to December 31, 2027, allowing doctors to recertify hospice eligibility remotely. However, starting January 1, 2026, telehealth recertifications are blocked in areas with hospice enrollment moratoriums, for providers under enhanced oversight, and for physicians not properly enrolled—and all telehealth recertifications must be flagged with a modifier code so Medicare can track them.
Why we flagged it
The bill extends a telehealth convenience but simultaneously narrows it with three enforcement carve-outs and adds tracking requirements. It is neither a pure expansion nor a pure restriction—it is a conditional extension paired with regulatory tightening on a subset of hospice providers.
What the text implies
- The modifier requirement creates a new data-collection mechanism that allows CMS to identify and potentially audit or restrict telehealth recertifications by provider, potentially enabling future enforcement actions based on usage patterns.
- Patients in areas with hospice enrollment moratoriums (typically imposed due to quality or fraud concerns) are explicitly denied telehealth access, which may increase burden on already-vulnerable populations in problem areas.
- The carve-out for unenrolled physicians or those not opted-out under section 1802(b)(6)(D) may inadvertently exclude legitimate practitioners who have not completed enrollment paperwork, creating access gaps unrelated to quality.
- The December 31, 2027 sunset creates a cliff—telehealth recertifications revert to in-person-only on January 1, 2028 unless Congress acts, potentially disrupting established workflows.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Patients in compliant hospice programs retain convenient remote recertification access, reducing travel burden and potentially speeding care decisions. However, patients in moratorium areas or under providers subject to enhanced oversight lose telehealth access, creating a two-tier system; the modifier requirement itself is administrative but may enable tighter enforcement that could restrict access if misused.
Who stands to gain
- Compliant hospice providers (reduced travel/administrative burden)
- Telehealth technology vendors serving hospice sector
- Hospice physicians and nurse practitioners in non-moratorium areas
Named in the bill
Medicare (Title XVIII, Social Security Act), CMS (Centers for Medicare & Medicaid Services), Hospice providers, Hospice physicians and nurse practitioners, Section 1814(a)(7)(D)(i)(II) Social Security Act, Section 1866(j)(7) Social Security Act (enrollment moratoriums), Section 1866(j)(3) Social Security Act (enhanced oversight), Section 1802(b)(6)(D) Social Security Act (opt-out physicians)
Where it stands
5 cosponsors: 3 Democrats, 2 Republicans.
- Feb 27, 2025 — Introduced · Congress.gov: “Introduced in House”
- Feb 27, 2025 — Referred to House Committee on Ways and Means · Congress.gov: “Referred to the House Committee on Ways and Means”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
4 lobbying clients named this bill on 7 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $470,000 in lobbying spend. A filing names 10 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 72% of bills with at least one filing.
Carol Miller, the sponsor, reported $1,295,500 in PAC receipts in the 2026 cycle.
- Vitas Healthcare Corporation — $230,000 on 1 filing
- The National Alliance for Care at Home — $100,000 on 2 filings
- Vitas Healthcare — $100,000 on 2 filings
- Ata Action — $40,000 on 2 filings
Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (1,532 characters) on Jul 2, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-10-20.
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