Preparing for the Shift: The FY 2027 Changes

Author: Quality in Hospice Consulting

Date: June 1, 2026

The Centers for Medicare & Medicaid Services (CMS) recently dropped the Fiscal Year (FY) 2027 Hospice Proposed Rule, and it includes a massive shift in how we handle patient admissions and financial transparency. If you’ve been treating the Hospice Election Statement Addendum as an "only if they ask" form, it’s time to rethink your entire intake workflow.

Under the new proposal, providing this addendum will become completely mandatory for all Medicare beneficiaries at the time of hospice election.

Why CMS is Making the Change?

When CMS first introduced the addendum in FY 2020, the goal was to give patients transparency regarding what items, services, or drugs the hospice determined were unrelated to their terminal illness. However, CMS data shows that non-hospice spending has continued to climb.

The agency believes many families simply don't know they have the right to ask for the form. By making it mandatory across the board, CMS aims to protect patients from unexpected out-of-pocket expenses and hold agencies more accountable for the holistic care they are required to provide.

The Operational Impact on Your Agency

This is more than just a paperwork update; it requires a proactive shift in clinical and administrative processes:

• Intake Restructuring: Your admission teams must be trained to complete and issue this addendum right at election, rather than waiting for a request.

• Interdisciplinary Alignment: The clinical team must clearly and defensively document exactly why a specific service or medication is deemed unrelated to the terminal diagnosis.

• B2B Transparency: The addendum will also serve as a crucial tool for non-hospice providers in your community to ensure accurate claims submissions without overlapping hospice benefits.

The Takeaway: Start reviewing your admission packets and training your staff now. Transitioning your workflow ahead of the final rule will save your agency from compliance bottlenecks later this year.

Quality is Intentional!

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