Hospice and Palliative Care

Part of LeadingAge's 2020 Policy Priorities

LeadingAge Advocacy Goals

  • Realize the full integration of hospice services into the continuum of care.
  • Ensure appropriate reimbursement to provide quality end-of-life care.
  • Promote access to and use of appropriate palliative and end-of-life care in all health and long-term care settings.
  • Work for reasonable hospice regulations to allow quality, community-based care without unnecessary burdens.

The Issue

Overall, hospice enjoys positive public perception from those who have received it, from the public at large, and from policymakers. However, as hospice has grown from a volunteer-driven, grassroots movement into an $18 billion portion of the Medicare program, policymakers are taking a closer look at the hospice benefit and more questions are arising regarding how to define quality hospice care and provide effective oversight. Additionally, as the complexity of illness trajectories increase and more treatment options emerge, so does the choice to go on hospice both from a policy and personal perspective. LeadingAge is engaged with policymakers both on current legislative and regulatory issues about the current benefit and how to make it accessible and of the highest quality for today, but also will engage in thought leadership on the future of hospice and palliative care needs.

Advocacy Action 2020

116th Congress

  • Hospice Oversight: We support the Hospice Care Improvement Act of 2019 (S. 2807), which aims to improve the quality of care furnished by Medicare hospice programs through increased oversight, transparency, and education. We support portions of the House counterpart, HOSPICE Act (H.R. 5821), but do not support the addition of civil monetary penalties (CMPs) to the hospice program nor the increase in survey frequency.
  • Access to Telehealth: We support the CONNECT for HEALTH Act of 2019 (S. 2741/H.R. 4932) to amend Medicare to expand access to telehealth, including the provision that allows the hospice face-to-face recertification to take place via telehealth.
  • Training in Palliative Care: We support the Palliative Care Education and Training Act (PCHETA; S. 2080/ H.R. 647) which would provide professional training in palliative care and has passed the House.
  • Palliative Care Access: We support the Provider Training in Palliative Care (S. 1921) to allow the definition of primary care provided by the National Health Service Corps to include palliative care services.
  • Rural Health Clinics and Hospice: We support the Rural Access to Hospice Act (S. 1190/H.R. 2594) to amend the Social Security Act to provide payments for certain rural health clinics and federally qualified health center services provided to hospice patients under Medicare.
  • Older Americans Act Reauthorization: We support the reauthorization of Older Americans Act (Dignity in Aging Act; H.R. 4334) to include provisions focused on serious illness. The Dignity in Aging Act (H.R. 4334) has passed the House and been introduced in the Senate.
  • Advanced Illness Care: We support the Removing Barriers to Person Centered Care Act (S. 829) to award cooperative agreements to improve care for individuals with advanced illness.
  • Physician Assistants: We seek a legislative fix to the statute that does not allow for PAs to provide face-to-face encounters. We also seek to provide clarity around the role of physician assistants in hospice.
  • Integration of Hospice and Palliative Care into the Continuum of Aging Services: We seek legislative provisions that would enable such integration.

Executive Branch

Actions You Can Take Now

  • Visit the Advocacy Action Center to let your representative and senators know that you support quality hospice and palliative care.
  • Host a Coffee Chat with Congress in your community to help your members of Congress understand how policies impact hospice and palliative care.
  • Mobilize with the Advocacy Champions toolkit and let your representatives and senators know you support more opportunities to provide quality hospice and palliative care services.

Additional Resources