For Immediate Release
April 17, 2023

(Alexandria, VA) The National Hospice and Palliative Care Organization (NHPCO) published the following statement in response to a recent Centers for Medicare & Medicaid Services (CMS) proposed rule that would update key components of hospice reimbursement and regulations in Fiscal Year (FY) 2024.

Since the publication of the proposed rule, NHPCO has heard from hospice members across the country. Those conversations spotlighted opportunities and a significant concern contained in the FY 2024 Hospice Wage Index and Quality Reporting Proposed Rule.


      • The 2.8% proposed rate increase for hospices is not enough to support the care hospices provide. Hospices are dealing with inflation rates that are at least twice that high, compounded by historical and ongoing workforce challenges. In 2024, pre-determined sequestration cuts will further reduce hospice reimbursement to a de facto increase of about 1%. Americans are increasingly choosing hospice for end-of-life care. Intentionally underfunding that care should be a non-starter.


      • CMS is using the proposed rule to advance hospice program integrity measures, curb fraudulent and abusive practices within the system, advance health equity, and increase hospice utilization. These efforts are in line with NHPCO’s ongoing work, including 34 program integrity recommendations made in January. NHPCO will work with the hospice community and CMS to help shape the following efforts:
          • The proposed rule would require physicians to be enrolled in Medicare to certify and recertify patients for hospice care. If designed and implemented properly, NHPCO believes this measure may help identify physicians who are engaging (or potentially engaging in fraudulent or abusive behavior, presenting a risk of harm to Medicare beneficiaries or are other unqualified to certify or recertify beneficiaries for hospice.
          • In this proposed rule, CMS announced it is soliciting feedback from providers via two Requests for Information (RFIs) – one on health equity in hospice and the other on hospice utilization, non-hospice spending, ownership, and hospice election. NHPCO welcomes the opportunity to provide feedback and is soliciting detailed comments from providers for both RFIs. CMS will have significant on-the-ground experiences from providers to inform these important issues around access, equity, and the integrity of the Medicare hospice benefit.

Recent independent research demonstrates that hospice care resulted in reduced Medicare spending of $3.5 billion in 2019, while benefiting patients, families, and caregivers. The benefits for patients, family members, and caregivers include increased satisfaction and quality of life, improved pain control, reduced physical and emotional distress, and reduced prolonged grief and other emotional distress. No other area of healthcare delivers such high value for patients and for Medicare. Pair that with two decades of growth in the number of Americans choosing hospice care, and it’s clear that hospice is a smart investment. Through the FY 2024 process and beyond, NHPCO will continue working with CMS to ensure access to hospice care and the integrity of the hospice benefit.


The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers.

Press Contact:
Madison Summers
NHPCO Communications
Ph: 571-412-3973