LeadingAge signed onto a letter with the National Hospice and Palliative Care Association and the National Association for Home Care and Hospice opposing the implementation of the MedPAC recommendation to wage adjust and cut the hospice aggregate cap to pay for end of the year priorities. Wage adjustment and a reduction of the aggregate cap are complex policy issues and should be considered through regular order rather than as a bucket of available money that can be used as a “pay for” priorities unrelated to hospice care. There needs to be a full understanding and accounting of the potential impact of an across-the-board cap cut on patients, families, and providers. LeadingAge does believe that lowering the hospice aggregate cap is important policy but any savings derived from reducing the cap needs to be driven back into the hospice benefit to improve it for hospice patients and their families.