Hospice Recertification Flexibility Act

Bill: 119-hr-1720
Sponsor: full_name: Rep. Miller, Carol D. [R-WV-1]
Introduced: 2025-02-27
Policy area: Health
Subjects: Health care coverage and access

Health technology, devices, supplies

Long-term, rehabilitative, and terminal care

Medicare
Latest action: action_date: 2025-02-27
text: Referred to the House Committee on Ways and Means.

Summaries:
action_date: 2025-02-27
action_desc: Introduced in House
text: <p><strong>Hospice Recertification Flexibility Act</strong></p><p>This bill extends until December 31, 2027, the ability of physicians and nurse practitioners to fulfill certain requirements for hospice care recertification under Medicare via telehealth.</p><p>Specifically, physicians and nurse practitioners may continue to fulfill the requirement of a face-to-face encounter with the hospice patient via telehealth. Such telehealth encounters must be identified with a specialized claims modifier for purposes of billing.</p><p>The bill's authorization does not apply (1) in areas in which there has been a moratorium for at least six months on the enrollment of new hospice programs under Medicare, Medicaid, or the Children's Health Insurance Program (CHIP) due to fraud, waste, or abuse; (2) to providers who are subject to enhanced oversight under Medicare, Medicaid, or CHIP; and (3) to practitioners who are not enrolled as Medicare providers and who have private contracts with Medicare patients that do not meet applicable opt-out requirements.</p>

tv_txt: I 119th CONGRESS 1st Session H. R. 1720 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.

1. Short title This Act may be cited as the Hospice Recertification Flexibility Act . 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. 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 .