FY 2027 Hospice Proposed Rule (finalized as CMS-1851-F): a 2.4% update — and a public score for every hospice

Update (6 Oct 2026): CMS finalized this rule as CMS-1851-F (91 FR 49118, August 3, 2026), effective October 1, 2026. The figures below are the proposed figures; see our final-rule article for what was finalized, including the mandatory election statement addendum.

Issued April 2, 2026, CMS-1851-P proposes a 2.4% hospice payment update for FY 2027 — a 3.2% market basket increase minus a 0.8 point productivity adjustment — raising the aggregate cap to $36,210.11. Hospices that fail quality-data submission requirements face the statutory four-point penalty, a net −1.6%.

The lasting story is the SSVI. CMS built a scoring system from nine claims-based measures spanning non-hospice spending during hospice elections, long-stay live discharge patterns, routine home care visit intensity, and rapid readmission to the same hospice after live discharge. Scores for FYs 2024 and 2025 — provider by provider — were published alongside the proposed rule on the CMS Hospice Center page. A higher score flags patterns CMS associates with potential inappropriate utilization or compliance concern; the agency is explicit that the index will guide program-integrity targeting: medical review, education, investigation, and potentially payment suspension.

Also in the rule: quality-reporting continuity for the HOPE instrument (with public reporting still anticipated around November 2027), a proposed Care Compare icon flagging hospices that miss reporting requirements beginning no earlier than FY 2028, and requests for information on community palliative care, a hospice-specific wage index, and the intersection of hospice with medical aid in dying.