Neal, Sánchez Release New GAO Report Finding the Necessity of Sánchez’s Hospice CARE Act
WASHINGTON, DC—Ways and Means Committee Ranking Member Richard E. Neal (D-MA) and Ways and Means Trade Subcommittee Ranking Member Linda T. Sánchez (D-CA) today highlighted a new report from the nonpartisan U.S. Government Accountability Office (GAO) finding that Congress must reform the Medicare hospice benefit to address misaligned payment incentives, reduce excessive spending, and root out fraudsters. Neal requested this report back in May 2023, and Sánchez leads legislation to modernize the Medicare hospice benefit while also safeguarding against fraud.
"Hospice care exists to ensure patients and families receive compassionate, high-quality support during some of life's most difficult moments,” said Ranking Member Neal and Congresswoman Sánchez. “With Medicare hospice spending nearly doubling over the past decade, Congress has a responsibility to ensure payments reflect the care patients actually receive and we’ve long suspected that some providers are falling short. Today’s report confirms that updates are necessary to root out bad actors, reward high-quality providers, and ensure that the Medicare program is efficiently spending taxpayer dollars on hospice care. That's why we have pushed for reforms to modernize the hospice payment system, strengthen oversight, and better align incentives with high-quality patient care. Patients deserve a hospice benefit that puts their needs first, and taxpayers deserve confidence that every Medicare dollar is being spent wisely."
The report recommends Congress direct the Department of Health and Human Services (HHS) to revise the hospice payment system to better promote efficiency, protect Medicare resources, and realize savings for the Medicare program—the core goal of Sánchez’s Hospice CARE Act. The report also confirmed that the Center for Medicare and Medicaid Services does not have the authority to further adjust hospice payments without congressional approval.
GAO found that the low-visit hospices, delivering the fewest visits per week, averaged about half as many visits as the high-visit hospices, yet because Medicare’s hospice daily payment rates are the same regardless of number of visits, both received the same daily Medicare payment rates. The report estimates Medicare spent approximately $16.7 billion on routine hospice home care from 2022 through 2024, compared to an estimated $9.1 billion of comparable services had been reimbursed using home health payment rates—a difference of roughly $7.6 billion.
The full GAO report is available HERE.
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