Congress locks out new hospice programs for 5 years, reshapes end-of-life care.
H.R. 7966 — Hospice CARE Act of 2026 · Filed by Linda Sánchez (D-CA) · 6 cosponsors · Introduced Mar 17, 2026 · Referred to committee
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What it does
The Hospice CARE Act imposes a 5-year moratorium on new hospice program enrollment under Medicare, with exemptions for underserved areas. It requires enhanced oversight of newly enrolled programs, mandatory revalidation of ownership information, and stricter physician independence rules for terminal illness certifications. The bill also restructures hospice payment rates, adds new palliative care services (chemotherapy, dialysis, transfusions), and increases survey frequency for programs with aberrant billing patterns.
Why we flagged it
The bill's core function is to combat fraud and abuse in Medicare hospice programs through enrollment controls, ownership transparency, and stricter oversight, while simultaneously restructuring payment rates to account for new palliative care services and cost variations.
What the text implies
- The 5-year enrollment moratorium may disproportionately harm rural and underserved communities by preventing new hospice programs from entering markets, even where exemptions exist—the exemption process is discretionary and may be slow or difficult to navigate.
- Payment restructuring for palliative chemotherapy, dialysis, and transfusions at 400% of FY2027 rates creates significant financial incentives for hospice programs to pursue aggressive end-of-life oncology and nephrology interventions, potentially conflicting with traditional hospice philosophy of comfort care.
The full analysis lists 5 implications of this text.
Who stands to gain
Hospice programs with strong compliance infrastructure and access to oncologists/nephrologists; Larger, well-capitalized hospice chains with resources for enhanced oversight; Specialty palliative care providers (oncology, nephrology)