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Hospice Recertification Flexibility Act
To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities with respect to hospice care under the Medicare program, and to establish a modifier for recertifications of hospice care eligibility conducted through telehealth.
Summary
This bill extends Medicare telehealth flexibilities for hospice care recertifications through December 31, 2027, which were previously scheduled to expire in March 2025. Starting in 2026, the bill adds restrictions on when telehealth can be used for hospice recertifications, excluding certain areas with enrollment moratoriums and providers subject to enhanced oversight. The bill also requires hospice claims for telehealth encounters to include specific modifiers or codes to identify them as conducted via telehealth.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
5 cosponsors
Actions (2)
- Feb 27, 2025 Referred to the House Committee on Ways and Means. · house
- Feb 27, 2025 Introduced in House
More bills on these subjects (8)
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Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
February 27, 2025
Mrs. Miller of West Virginia (for herself, Mr. Golden of Maine, Ms. Van Duyne, Mr. Davis of North Carolina, Mr. Bean of Florida, and Mr. Morelle) introduced the following bill; which was referred to the Committee on Ways and Means
A BILL
To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities with respect to hospice care under the Medicare program, and to establish a modifier for recertifications of hospice care eligibility conducted through telehealth.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Hospice Recertification Flexibility Act”.
SEC. 2. EXTENSION OF CERTAIN TELEHEALTH FLEXIBILITIES.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended—
(1) by striking “ending on March 31, 2025” and inserting “ending on December 31, 2027”; and
(2) by inserting “, except that this subclause shall not apply in the case of such an encounter with an individual occurring on or after January 1, 2026, if such individual is located in an area that has been subject to a moratorium on the enrollment of hospice programs under this title pursuant to section 1866(j)(7) for a period of not less than 6 months, if such individual is receiving hospice care from a provider that is subject to enhanced oversight under this title pursuant to section 1866(j)(3), or if such encounter is performed by a hospice physician or nurse practitioner who is not enrolled under section 1866(j) and is not an opt-out physician or practitioner (as defined in section 1802(b)(6)(D))” before the semicolon.
SEC. 3. ESTABLISHMENT OF MODIFIER FOR RECERTIFICATIONS OF HOSPICE CARE ELIGIBILITY CONDUCTED THROUGH TELEHEALTH.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)), as amended by section 2, is further amended by inserting “, but only if, in the case of such an encounter occurring on or after January 1, 2026, any hospice claim includes 1 or more modifiers or codes (as specified by the Secretary) to indicate that such encounter was conducted via telehealth” after “as determined appropriate by the Secretary”. <all>
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