Section 1 Short title
This Act may be cited as the “Hospice Recertification Flexibility Act”.
Hospice Recertification Flexibility Act
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.
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—
by striking “ending on March 31, 2025” and inserting “ending on December 31, 2027”; and
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”.