The Hospice CARE Act of 2026 implements comprehensive reforms to the Medicare hospice program aimed at preventing fraud and abuse while improving patient protections. The bill establishes a five-year moratorium on new hospice program enrollment (with exceptions for underserved areas), strengthens federal oversight through enhanced monitoring and prepayment claim reviews, and requires new data reporting starting in fiscal year 2028. Key accountability measures include mandatory ownership change disclosures with advance notice requirements, stricter terminal illness certification rules to prevent financial conflicts of interest, and specialized training for claim reviewers by January 2028, with approximately $30 million allocated for implementation. Beginning in 2029, the bill restructures Medicare payment formulas to separate routine home care into per-diem and per-visit components, expands payment for specified palliative services, and creates new home respite care benefits while restricting certain aide services in nursing facilities—with additional payment adjustments to be analyzed in 2026, 2031, and 2036.
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