2027 PROPOSED RULES HOSPICE
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
CMS Posts Proposed FY 2027 Hospice Wage Index and Payment Rate Update
The Centers for Medicare and Medicaid Services (CMS) are issuing a proposed rule to update the hospice wage index, payment rates, and cap amount for FY 2027 as required under section 1814(i) of the Social Security Act (the Act).
The proposal also includes an analysis of Medicare non-hospice spending under a hospice election, including details regarding a hospice spending variation index (SSVI). The SSVI includes a scoring system that monitors nine claims-based metrics in order to comprehensively assess hospice services and yield a provider ranking that can be utilized by beneficiaries to make more informed health decisions and support program integrity efforts.
The rule also proposes to require that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, the proposed rule proposes conforming regulation text changes to allow a physician designee or physician member of the interdisciplinary group (IDG), in addition to the hospice medical director, to discharge a patient from hospice care.
The proposal also includes conforming regulation text changes to the hospice telehealth face-to-face policy for the sole purpose of hospice recertification codified at § 418.22(a)(4)(ii) to align with the end date and new requirement to include modifiers or codes for such encounters as set forth in statute at section 1814(a)(7)(D)(i)(II) of the Act, as well as a subclause that prohibits the use of telehealth to conduct the face-to-face encounter in specific situations related to moratoriums (section 1866(j)(7) of the Act), enhanced oversight (section 1866(j)(3) of the Act), or enrollment status (section 1866(j) of the Act).
The rule also includes requests for information (RFI) on enhancing community palliative care services under current Medicare benefits, the construction of a hospice specific wage index using Bureau of
Labor Statistics (BLS) data, and the overlap between hospice and medical aid in dying (MAID).
Finally, this rule proposes adding an icon to the Medicare.gov Compare Tool as part of the
Hospice Quality Reporting Program (HQRP), in addition to other updates to the HQRP.
The proposal is scheduled for publication in the Federal Register on April 6. A copy is currently available at: https://public-inspection.federalregister.gov/2026-06604.pdf. A 60-day comment period is provided.