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HR 1720119th CongressIn Committee
Hospice Recertification Flexibility Act
Introduced: Feb 27, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs
Hospice Recertification Flexibility Act would (1) extend the Medicare telehealth option for hospice care recertifications through December 31, 2027, with a specific exception that narrows the flexibility for certain encounters beginning January 1, 2026, and (2) require a telehealth indicator modifier on hospice claims for recertifications conducted via telehealth starting January 1, 2026. In practical terms, the bill aims to preserve and later codify the ability for clinicians to conduct hospice eligibility recertifications remotely (telehealth) beyond current deadlines, while adding guardrails in certain restricted situations. It also creates a standardized way to flag telehealth recertifications on Medicare claims.
Key Points
- 1Extends the telehealth flexibilities for hospice care recertifications under Medicare from the current end date (March 31, 2025) to December 31, 2027.
- 2Adds a limited exception to the extension: starting January 1, 2026, telehealth flexibilities do not apply if the encounter is in an area with a hospice enrollment moratorium of at least 6 months, if the provider is subject to enhanced oversight, or if the encounter is performed by a hospice physician or nurse practitioner who is not enrolled under Medicare or is not an opt-out physician/practitioner.
- 3Beginning January 1, 2026, requires hospice claims for telehealth encounters to include one or more modifiers or codes to indicate the encounter was conducted via telehealth, with the specific modifiers/codes to be specified by the Secretary of Health and Human Services.
- 4The changes relate specifically to the Medicare program (Title XVIII of the Social Security Act) and do not create new coverage types beyond extending telehealth recertification options and adding billing indicators.
- 5The bill is named the Hospice Recertification Flexibility Act and was introduced in the House with referral to the Ways and Means Committee.
Impact Areas
Primary group/area affected: Medicare hospice patients and their providers. The extension could reduce travel burdens for patients and caregivers and help clinicians perform timely recertifications remotely.Secondary group/area affected: Hospice clinicians (physicians and nurse practitioners), hospice programs, and other telehealth-service providers who perform hospice recertifications; billing and compliance staff will need to implement and manage telehealth modifiers.Additional impacts: Medicare claims processing and data collection will require updates to recognize telehealth modifiers and to apply the exception criteria for encounters in restricted areas or by non-enrolled/opt-out providers. Rural or underserved areas may particularly benefit from extended telehealth access, though certain high-scrutiny situations (moratorium areas, enhanced oversight, or non-enrolled providers) could limit telehealth use after 2025/2026. Overall, the bill could affect access to hospice recertification, provider workload, and Medicare spending patterns related to hospice services.
Generated by gpt-5-nano on Nov 18, 2025