Hospice & Home Health News 2026June12

GAO releases report on hospice payment.

On June 9, the Government Accountability Office (GAO) released a report entitled Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care. The report covers the frequency of hospice routine home care visits and how estimated per-visit payment rates for hospice routine home care compare across selected hospices as well as to home health per-visit payment rates. The report divides hospices into quintiles based on visits with the lowest quintile ("low visit hospices") averaging 2.5 visits per beneficiary per week and the highest quintile (high visit hospices) averaging 5.5 visits per beneficiary per week. The report concludes that because Medicare’s hospice daily payment rates are the same regardless of the number of visits delivered, Medicare effectively paid low-visit hospices twice as much per visit as high-visit hospices, on average. GAO also concluded that Medicare effectively paid more per visit under hospice payment rates than it would have under rates for comparable home health visits. LeadingAge generally supports hospice payment reform but has not taken a position on whether a per visit model for routine home care is the best path forward. LeadingAge is still reviewing the details and methodology of report and will write a comprehensive summary in the coming days. LeadingAge will also use the July Hospice Member Network meeting to dive into this issue in more detail with members and asks that hospice members read the report and come prepared to discuss how what GAO prepared aligns or does not align with their experience and cost profile.

Hospice PEPPER Reports Ready for Download: What's Changed and What's Next. 

The Centers for Medicare and Medicaid Services (CMS) released the FY 2025 Program for Evaluating Payment Patterns Electronic Report (PEPPER) for hospices. PEPPER helps hospices review billing data to make sure claims are accurate. Members can learn how to access their reports here. In addition to the individual hospice reports, CMS released a User Guide for hospices and a sample report. The User Guide outlines what has changed in the report. First, top terminal diagnosis categories are updated to follow the more current Clinical Classifications Software Refined (CCSR) diagnosis categories. Second, the reports will have one target area removed: Continuous Home Care (CHC) Provided in an Assisted Living Facility (ALF). And finally, one target area updated: Long Length of Stays now includes episodes with length of stay equal to or greater than 180 days. Previously, only episodes with a length of stay greater than 180 days met the numerator criteria. On May 28, CMS announced that PEPPER reports are relaunching for all Medicare facilities types including home health and skilled nursing.

Hospice PEPPER Webinar June 24. 

The Centers for Medicare and Medicaid Services (CMS) will host a webinar on Wednesday, June 24 at 1 p.m. ET to provide hospices and stakeholders with guidance on navigating the recent changes to the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for hospices. This will also include a review of the reports published in June 2026. Attendees can submit questions to CMS_CBRPEPPER@cms.hhs.gov. Sign up for the webinar here.