[UPDATED] Senate Bill Would Allow Telehealth for Hospice Face-to-Face Encounters, Pause Sequestration

Provisions of a massive stimulus package currently being debated in the U.S. Senate would allow hospices to use telehealth in lieu of face-to-face encounters as well as temporarily ending the practice of sequestering 2% of hospice payments from the U.S. Centers for Medicare & Medicaid Services (CMS).

The Coronavirus Aid, Relief, and Economic Security Act, also called the CARES ACT, is designed to stimulate the economy and provide aid to businesses and individuals reeling from the impact of the COVID-Pandemic.

“We are in effect shutting the economy down. We have to, because of the public health crisis. So that is very different from the 2008 financial crisis, or 9/11 when we were hit by terrorists. It’s a very different thing and the key to this, clearly, is get past this and bend the curve as Dr. [Anthony] Fauci continues to tell us,” Senate Majority Leader Mitch McConnell said in a press release. “And that requires this kind of isolation that shuts down the economy. It’s our job to step in and help people through what we hope will be a short term shut down of our economy.”


Anthony Fauci is the current head of the National Institute of Allergy and Infectious Diseases.

CMS Conditions of Participation currently require hospice physicians to conduct a face-to-face visit in order to certify or recertify patients for hospice care. Earlier in the crisis, CMS took steps to temporarily expand the use of telehealth, but hospice face-to-face encounters were not included.

If enacted, the bill would also temporarily suspend sequestration. Under the auspices of the Budget Control Act, CMS in 2014 began reducing payments to hospice providers by 2% across the board. Under current law, a hospice provider must return payments to CMS if the total paid exceeds the Medicare payment cap allowance. Presently, CMS includes the sequestered 2% as part of the total, even though hospice providers never received those funds.


On Sunday evening, the bill stalled in the Senate due to disagreements between the parties, the Washington Post reported. Lawmakers said that negotiations on the bill would continue through the night if necessary, and the House indicated that they would be developing their own legislation.

If passed by the Senate, the bill would then go to the House of Representatives. Then in most instances legislation would go to what is called a conference that would reconcile any differences between the Senate and House versions.