President Obama Signs Law To Bring Oversight to Hospices

President Obama signed into law a bill to create greater oversight within the hospice community.

The Improving Medicare Post-Acute Care Transformation Act, or IMPACT Act (H.R. 4994), received support from both Democrats and Republicans, and received praise from multiple health care and senior living organizations.

The IMPACT Act also requires more frequent surveys of hospice providers – a measure the hospice community and the National Hospice and Palliative Care Organization (NHPCO) has championed for more than a decade, the agency said in a news release. The bill mandates that all Medicare certified hospices be surveyed every three years for at least the next 10 years.


The law will also create increased transparency within the hospice community, which has faced increased scrutiny. 

A report, published last year, by the U.S. Department of Health and Human Services’ Office of Inspector General found the frequency of surveys of hospice were inconsistent. Some facilities even went years without an evaluation. 

“More consistent surveys, and the process providers go through to prepare for them, will help hospices and ultimately benefit the patients and families in their care,” said J. Donald Schumacher, NHPCO president and CEO, in a written release.


The law also mandates that the hospice aggregate financial cap will be aligned with hospice reimbursement using a common inflationary index that will not change hospice reimbursement for providers.

In addition, the law will standardize data used by post-acute care providers.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) also said it applauds the new law. 

“The signing of the IMPACT bill by President Obama closes one process and opens new opportunities to enhance the quality care we deliver every day,” said AHCA/NCAL President and CEO Mark Parkinson in a written statement. “We look forward to working with both the Administration and Congress on implementing this important law, particularly to ensure the new quality measures are helpful to those we care for and their families.”

The IMPACT Act provides Congress with new payment models to consider for future reforms and protects beneficiary choice and access to care, according to language in the IMPACT Act.

“The lack of comparable information across [post-acute care] PAC settings undermines the ability of policymakers and providers to determine appropriate care settings for patients based on clinical evidence and quality metrics and differentiate between PAC providers,” the Act says, noting that the legislation will enable Medicare to compare quality across PAC settings; improve hospital and PAC discharge planning; and use this information to reform PAC payments while ensuring continued beneficiary access to the most appropriate setting of care.

The Act is slated to roll out in phases through 2022.

Written by Cassandra Dowell

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