Bill Details
View committees (1)
AI Summary This summary was generated by AI from the bill text. AI can get information wrong.
This bill would continue Medicare rules that let hospice doctors and nurse practitioners use telehealth for some hospice care recertifications, instead of having to meet in person, through the end of 2027. It also adds a new billing code marker so Medicare can tell when one of these recertification visits happened by telehealth. The bill keeps this flexibility, but adds some limits starting in 2026 for certain high-risk situations and for providers who are not properly enrolled.
- It extends the current telehealth hospice flexibility from March 31, 2025, to December 31, 2027.
- Starting January 1, 2026, the telehealth option would not apply in some cases, including certain areas with a hospice enrollment moratorium, providers under enhanced oversight, or visits by hospice doctors or nurse practitioners who are not enrolled as required.
- For telehealth recertification visits on or after January 1, 2026, Medicare claims would need a special modifier or code to show the visit was done through telehealth.
Official Summaries
Hospice Recertification Flexibility Act
This bill extends until December 31, 2027, the ability of physicians and nurse practitioners to fulfill certain requirements for hospice care recertification under Medicare via telehealth.
Specifically, physicians and nurse practitioners may continue to fulfill the requirement of a face-to-face encounter with the hospice patient via telehealth. Such telehealth encounters must be identified with a specialized claims modifier for purposes of billing.
The bill's authorization does not apply (1) in areas in which there has been a moratorium for at least six months on the enrollment of new hospice programs under Medicare, Medicaid, or the Children's Health Insurance Program (CHIP) due to fraud, waste, or abuse; (2) to providers who are subject to enhanced oversight under Medicare, Medicaid, or CHIP; and (3) to practitioners who are not enrolled as Medicare providers and who have private contracts with Medicare patients that do not meet applicable opt-out requirements.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1720 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 1720
To amend title XVIII of the Social Security Act to extend certain
telehealth flexibilities with respect to hospice care under the
Medicare program, and to establish a modifier for recertifications of
hospice care eligibility conducted through telehealth.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 27, 2025
Mrs. Miller of West Virginia (for herself, Mr. Golden of Maine, Ms. Van
Duyne, Mr. Davis of North Carolina, Mr. Bean of Florida, and Mr.
Morelle) introduced the following bill; which was referred to the
Committee on Ways and Means
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to extend certain
telehealth flexibilities with respect to hospice care under the
Medicare program, and to establish a modifier for recertifications of
hospice care eligibility conducted through telehealth.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Hospice Recertification Flexibility
Act''.
SEC. 2. EXTENSION OF CERTAIN TELEHEALTH FLEXIBILITIES.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)) is amended--
(1) by striking ``ending on March 31, 2025'' and inserting
``ending on December 31, 2027''; and
(2) by inserting ``, except that this subclause shall not
apply in the case of such an encounter with an individual
occurring on or after January 1, 2026, if such individual is
located in an area that has been subject to a moratorium on the
enrollment of hospice programs under this title pursuant to
section 1866(j)(7) for a period of not less than 6 months, if
such individual is receiving hospice care from a provider that
is subject to enhanced oversight under this title pursuant to
section 1866(j)(3), or if such encounter is performed by a
hospice physician or nurse practitioner who is not enrolled
under section 1866(j) and is not an opt-out physician or
practitioner (as defined in section 1802(b)(6)(D))'' before the
semicolon.
SEC. 3. ESTABLISHMENT OF MODIFIER FOR RECERTIFICATIONS OF HOSPICE CARE
ELIGIBILITY CONDUCTED THROUGH TELEHEALTH.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)), as amended by section 2, is further amended by
inserting ``, but only if, in the case of such an encounter occurring
on or after January 1, 2026, any hospice claim includes 1 or more
modifiers or codes (as specified by the Secretary) to indicate that
such encounter was conducted via telehealth'' after ``as determined
appropriate by the Secretary''.
<all>