Nearly 20 years have passed since the Centers for Medicare and Medicaid Services (CMS) last revised its Conditions of Participation (CoPs) for hospice care, which are health and safety requirements that all hospices participating in the Medicare program are required to meet.

With the administration’s focus over the past 18 months on addressing fraud, waste and abuse in government programs, and, more recently, identifying bad actors in hospice, the September 21, 2026 announcement by CMS’ Center for Clinical Standards & Quality (CCSQ), Clinical Standards Group (CGS) of plans to update hospice CoPs while identifying ways to reduce fraud and waste in the hospice realm and advance patient health and safety is not surprising.

In some cases, changes are arguably overdue. In recent years, for instance, LeadingAge—a strong supporter of the administration’s efforts to curb waste, fraud, and abuse—has urged CoP changes relating to hospice program integrity.

The work to amend the current CoPs begins with two virtual listening sessions geared towards different hospice administration and direct care staff. A third listening session will target families and caregivers.

LeadingAge members are highly encouraged to participate in these meetings and engage staff and families and patients as well. The outcomes of these conversations will shape the future of hospice care for decades to come.

Listening Sessions Details

Hospice Administration and Hospice Associations

Tuesday, October 6, 2026, from 2:00 – 3:00 p.m. ET.

Specifically, CMS is requesting feedback on barriers in the provision of hospice care and services, identifying any gaps existing in the health and safety requirements that may hinder effective/efficient hospice operations, and lastly, identifying barriers in current hospice regulations that affect the quality and safety of care provided to patients and families. 

1. Are there existing Conditions of Participation (CoPs) that no longer reflect how hospice care is delivered today? If so, which CoPs should CMS prioritize for modernization?
2. What operational challenges do hospices experience when trying to establish contracts with hospitals, rehabilitative therapists, etc.
3. What workforce challenges have had the greatest impact on your ability to provide hospice services?
4. What internal controls exist to prevent the enrollment of patients who do not meet hospice eligibility criteria?
5. Are physicians who certify terminal illness independent, or do they have a financial relationship with your hospice? How is this documented?

Please register HERE with your name, email, state, and whether you intend to provide verbal response during the session. We ask that registration be limited to subject matter experts who can offer informed feedback on the topics discussed.

Virtual Listening Session with Direct Hospice Health Care Staff

Tuesday, October 7, 2026, from 2:00 – 3:00 p.m. ET.

Specifically, CMS is requesting feedback on barriers in the provision of hospice care and services, identifying any gaps existing in the health and safety requirements that may hinder effective/efficient hospice operations, and lastly, identifying barriers in current hospice regulations that affect the quality and safety of care provided to patients and families. CMS will use the input from this listening session to evaluate its regulations.

1. What barriers prevent hospices from providing all Medicare-covered hospice services to patients?  
2. If a hospice chooses to employ a physician assistant (PA), what activities is the PA primarily engaged in?  
3. What policy changes would have the greatest impact on improving patient care while also reducing opportunities for fraud or inappropriate enrollment?  
4. In your role, how often do you interact with the hospice medical director? Please describe your interactions and experiences with the medical director.  
5. How has your hospice adapted its volunteer recruitment strategies in response to the challenges posed by the COVID-19 pandemic, such as reduced volunteer availability, hesitancy around in-person care, and increased competition for community volunteers? 
6. Are you utilizing virtual or remote volunteer roles (e.g., phone companionship, administrative support, telehealth assistance) to supplement in-person volunteering, and how are these roles documented toward the 5% requirement? 
7. How do you engage younger or non-traditional volunteer populations (e.g., college students, corporate volunteers, faith-based organizations) to diversity and grow your volunteer base post-pandemic?

Please register  HERE with your name, email, state, and whether you intend to provide verbal response during the session. We ask that registration be limited to subject matter experts who can offer informed feedback on the topics discussed.

Virtual Listening Session with Hospice Caregivers, Family, and Patients

Wednesday, October 14, 2026, from 2:00 – 3:00 p.m. ET.

Specifically, CMS is requesting feedback on barriers in the provision of hospice care and services, identifying any gaps existing in the health and safety requirements that may hinder effective/efficient hospice operations, and lastly, identifying barriers in current hospice regulations that affect the quality and safety of care provided to patients and families. CMS will use the input from this listening session to evaluate its regulations.

1. When your family member enrolled in hospice, did you feel you understood which services hospice would and would not provide? Were there aspects of hospice care that were confusing or difficult to understand?
2. If you could recommend one change CMS could make to improve the hospice experience for patients and families, what would it be?
3. When your family member enrolled in hospice, did the hospice team explain the four levels of hospice care and when each might be used?
4. Did the hospice team communicate clearly about the changes in your family member’s condition and updates to the care plan? Did they share this information in a timely manner?
5. How often did you feel that your family member needed services that were unavailable or difficult to access? Please describe these experiences.
6. Did the hospice provide bereavement support after your family member’s passing? If so, how soon after the passing did this support begin, and for how long were those services offered?

Please register HERE with your name, email, state, and whether you intend to provide verbal response during the session. We ask that registration be limited to subject matter experts who can offer informed feedback on the topics discussed.