The Centers for Medicare and Medicaid Services (CMS) on April 2, 2026 published the FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Proposed Rule.

In addition to a recommended payment update of 2.4%, the proposed rule includes extensive efforts to improve transparency and prevent fraud including a new Service and Spending Variation Index (SSVI).  And, in an enormous win for LeadingAge and the hospice sector, CMS also announced its decision to grant a waiver to all Hospice Outcomes and Patient Evaluation (HOPE) assessments dated October 1, 2025 to December 31, 2025, and consider these assessments timely.

Of the proposed payment rate, Linda Couch, SVP Policy, LeadingAge, said in an April 2 press statement: “The rule’s proposed payment rate update of 2.4% barely keeps up with inflation. Payment that scarcely covers the cost of services delivered threatens the ability of quality-focused, mission-driven providers to deliver needed care and potentially limits access for those who seek it.”

Of the proposed transparency measures and changes to regulations and quality measures, Couch said, also in the statement, “We generally support the agency’s efforts to increase transparency as part of their focus on enhancing oversight and strengthening program integrity. Increased transparency and a focus on quality will help beneficiaries to choose high quality providers like LeadingAge members.”

The SSVI will include metrics looking at non-hospice spending, percent of beneficiaries discharged with a length of stay of 180 days or more, average minutes per routine home care day, and percent of live discharges where beneficiaries return to the same hospice in seven days, among others. Under the proposed rule, these individual hospice SSVI’s would be posted on CMS’ hospice webpage but would not immediately indicate fraudulent practices.

Additionally, CMS proposes to add an icon on Care Compare for hospices that are non-compliant with Hospice Quality Reporting requirements.

Finally, CMS proposes to make a hospice election statement addendum mandatory for every hospice election. LeadingAge has previously not supported this concept due to the administrative burden to hospices.

We will have a full review of the proposed rule in the coming days.

The CMS fact sheet is here.