The Center for Medicare and Medicaid Services (CMS) in its July 10 MLN newsletter released another reminder to hospice providers on how to avoid improper payments.

As LeadingAge has previously reported, the Office of the Inspector General (OIG) found in 2024 that Medicare improperly paid acute-care hospitals for outpatient services provided to hospice enrollees.

To avoid improper payments, CMS is directing acute-care hospitals to request and analyze hospice election statement addendums for these enrollees and explicitly points out hospital’s responsibility to review the Acute Care Hospital Inpatient Prospective Payment System educational tool for more information.

The agency reminds acute-care providers that Medicare will not pay for services given in outpatient settings to palliate or manage a terminal illness and related conditions of a hospice enrollee. Such services should be provided under arrangements with the hospice provider. CMS only pays for Part B outpatient services that are unrelated to the terminal illness and related conditions. The CY2026 Hospital Outpatient PPS Policy Changes and Payment Rates is currently at the Office of Management and Budget awaiting release and may include additional guardrails for outpatient services rendered to hospice enrollees.