In LeadingAge’s June 1, 2026 comments to the Centers for Medicare and Medicaid Services (CMS) on the Fiscal Year 2027 (FY27) Hospice Wage Index, we raise concerns that the 2.4% payment update fails to keep pace with the true cost of care. We also highlight concerns that, if finalized, the proposals in this rule will add additional burden to hospices and have a chilling impact on older adults’ and families’ access to services.