Regulatory Updates to The Hospice CoP Handbook

The Hospice CoP Handbook: Meeting Federal Mandates from Admission to Audit reflects the requirements in 42 CFR Part 418 and CMS guidance. This page tracks verified changes to hospice regulations after publication. This page was last reviewed and updated on Sunday, March 8, 2026.

Check this page before applying any deadline, penalty figure, or documentation requirement from the book to your agency’s practice.

Current Edition

Second Edition — Published February 2026

HOPE Updates

All regulatory and technical updates affecting HOPE — and the chapters and appendices in this book that cover HOPE — are maintained at https://compassioncrossing.info/hope-updates/

Regulatory Updates — Newest First

• March 5, 2026 – Manual Guidance Aligned With FY 2026 Final Rule: It does not change 42 CFR Part 418 itself, but it explicitly interprets and operationalizes several CoP‑linked regulations, especially 42 CFR 418.22(b)(4), 418.26(c)(3), 418.28(c)(3), and 418.54.
  • Face‑to‑face attestation: signed, dated clinical note may satisfy attestation if it documents visit, findings, and practitioner signature/date.”
  • Transfers: no new NOE for receiving hospice; receiving hospice must complete all 418.54 assessments and may rely on prior F2F when verifiable.
  • Revocation and discharge: no waiting period before re‑election; patient may re-elect immediately if still eligible, per 418.28(c)(3) and 418.26(c)(3).
• October 1, 2025 — FY 2026 Final Rule: FY 2026 aggregate hospice cap increased to $35,361.44, up from $34,465.34 in FY 2025. (Affects Ch. 6, Ch. 11) — https://www.cms.gov/files/document/mm14190-hospice-payments-fy-2026-update.pdf​
• October 1, 2025 — FY 2026 Final Rule: FY 2026 payment rate increased 2.6%; agencies out of compliance with HQRP receive a net –1.4% adjustment instead. (Affects Ch. 6, Ch. 11) — https://www.cms.gov/newsroom/fact-sheets/fy-2026-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting-program​
• October 1, 2025 — FY 2026 Final Rule: IDG physician member is now formally authorized to recommend hospice admission, aligning the Conditions of Participation with existing certification and payment regulations. (Affects Ch. 1, Ch. 7) — https://www.federalregister.gov/documents/2025/08/05/2025-14782/medicare-program-fy-2026-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting​
• October 1, 2025 — FY 2026 Final Rule: Face-to-face encounter attestation requirement updated — a signed, dated clinical note now satisfies the requirement. A separate attestation form is no longer required. (Affects Ch. 1, Appendix A) — https://www.federalregister.gov/documents/2025/08/05/2025-14782/medicare-program-fy-2026-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting​
• October 1, 2024 — FY 2025 Final Rule: HQRP payment reduction confirmed at 4% for non-compliant agencies; CAHPS Hospice Survey items revised. (Affects Ch. 6, Ch. 11) — https://www.federalregister.gov/documents/2024/08/06/2024-16910/medicare-program-fy-2025-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting​
• October 1, 2024 — FY 2025 Final Rule: “Physician designee” definition clarified in §418.3 and in certification regulations. (Affects Ch. 1, Ch. 7) — https://www.federalregister.gov/documents/2024/08/06/2024-16910/medicare-program-fy-2025-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting​
• FY 2025, ongoing: Hospice Special Focus Program formally established. CMS now publicly identifies poor-performing agencies. (Affects Ch. 11) — https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/hospice-center​

Verify Any Citation in This Book

Every §418 citation in the handbook can be confirmed against current regulatory text here: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418