Sens. Roger Marshall, MD, (R-KS) and Sheldon Whitehouse (D-RI) sent a letter November 20 to congressional leaders urging them to reject any proposals that would roll the Medicare hospice benefit into the Medicare Advantage (MA) program. The senators argue that integrating hospice into the current MA program would jeopardize access by layering additional managed care terms (or policies) on top of an already managed and coordinated benefit. They also cite the failed Value Based Insurance Design (VBID) model, which identified clear challenges for both hospices and MA plans with administrative burdens, difficulty creating networks, and delayed payments for hospice claims. The demonstration also did not result in increased or earlier access to hospice or better care for patients.