Rep. Beth Van Duyne (R-Texas) has voiced a commitment to preserving the Medicare Hospice Benefit and has urged congressional colleagues to be wary about wholesale changes.

One potential change would be allowing coverage of hospice care through the Medicare Advantage program. Rep. David Schweikert (R-Ariz.) recently introduced the Medicare Advantage Reform Act. If enacted, the bill, numbered H.R. 3467, would overhaul aspects of Medicare Advantage (MA).

A key provision of the bill is a proposed requirement that MA plans pay for hospice care. Hospice is currently “carved out” of Medicare Advantage.

Van Duyne in an email to Hospice News shared her thoughts on the inclusion of hospice in MA and other legislation to aid seniors and facilitate timely access to health care.

How do you think that requiring hospice coverage through Medicare Advantage would affect terminally ill constituents and their families?

While we haven’t yet had committee conversations about a hospice carve-in policy, I have concerns about what hospice carve-in could potentially mean for beneficiaries. I worry that it could result in delayed or restricted access to hospice care, adding costs for families or even reducing the quality of life of their loved ones. 

We’ve already seen how delays and barriers from Medicare Advantage prior authorization can create unnecessary hardship. The last thing anyone should face at the end of life is a battle to access hospice care. No one should die waiting to get the help they need.

The current Medicare Hospice Benefit already saves Medicare money, is preferred by patients and families and serves Medicare Advantage patients who elect hospice services. 

We’ve tried adding hospice into Medicare Advantage before, and the pilot project was ended early. The hospice component of the [Center for Medicare & Medicaid Innovation] Medicare Advantage Value-Based Insurance Design (VBID) Model was terminated at the end of 2024 due to operational challenges.

Do you plan to oppose the Medicare Advantage Reform Act, or at least seek to change that proposed hospice requirement?

Hundreds of bills are introduced every day, resulting in meaningful conversations and discussions on many different topics. As such, each bill will go through the legislative process with the end goal of delivering the best possible bill that will increase access for patients while lowering costs. What I don’t want to see is families being forced to navigate red tape while trying to ensure their loved ones receive the right medications or services in hospice.

Which is why I am glad to support H.R. 3514, the Improving Seniors’ Timely Access to Care Act, which passed out of the [House] Ways and Means committee last Congress and would ensure no senior on Medicare Advantage is subject to unnecessary delays due to prior authorization.

Hospice care decisions should be made between a doctor and a patient, not dictated by insurance companies acting as a middleman.

I’m committed to working with all my colleagues to find better solutions that deliver meaningful change to the hospice benefit.

Are there ways to integrate provisions to protect patients and families from potential system failures or barriers to care?

It is imperative that we continue to protect timely access to high-quality hospice care for all Americans who need it. The current hospice benefit has largely proven successful in delivering that compassionate care, and I am working to continue to improve the patient experience.

Rather than supporting a solution in search of a problem, I will continue to work with my colleagues to enhance the existing hospice benefit for the patients and families that rely on it.