Bipartisan bill banning for-profit Hospices Lands on Hochul’s Desk

ALABNY, N.Y. (NEXSTAR) — New York hospice providers and advocates gathered at the State Capitol on Monday, calling on Governor Kathy Hochul to sign a bipartisan bill that would stop the creation of new for-profit hospice organizations in the state. The Hospice Care Integrity and Oversight Act passed both the Assembly and the Senate in April.

Hospice care is for those diagnosed with a serious illness that a doctor believes will kill them within six months. Hospice workers work with the patient and their family as they process the fear, anger, and grief that a life-threatening illness brings. The goal of hospice is living as long as possible with dignity and in comfort.

New York’s Public Health Law already requires the state’s Public Health and Health Planning Council to approve any new hospice establishment, construction, or capacity increase. S3437/A565, currently awaiting the governor’s signature, would block the council from approving new applications for establishing, incorporating, or constructing any hospice “operated on a for-profit basis or by a for-profit entity.”

The bill would also ban for-profit hospices from increasing capacity, while grandfathering in two for-profit hospices that already operate in New York. Right now, we have 39 other hospices, all nonprofits. But nationally, only a third in were non-profits as of 2017.

“That legacy is now under threat from venture capital-backed companies looking to enter New York and turn hospice into a business model in other states,” said Jeanne Chirco, President and CEO of the Hospice and Palliative Care Association of New York:

The legislation passed the Assembly with 99 votes in favor against 50 against, and passed in the Senate with 47 in favor and 13 opposed. Hochul previously vetoed a similar measure in 2022. To override a veto New York governor’s veto, a bill requires a two-thirds in both the Senate (42 votes) and the Assembly (100 votes).

At the press conference, advocates argued that hospices shouldn’t prioritize profit, but ought to instead focus on the mission of offering comfort and dignity to patients who have six months to live or less. They argued that for-profit operations incentivize low-quality hospice care.

That’s because hospice is covered by insurance. The federal Medicare hospice benefit covers it for most people, paying a fixed daily amount to the provider—known as the Medicare reimbursement—for a range of comprehensive services. For for-profit entities, the nature of the reimbursement encourages reducing patient services to maximize the fixed payout.

Nonprofit hospices rely on local fundraising to offer more than what insurance reimburses. For example, Hospice and Palliative Care Buffalo gets millions in community donations for services like palliative care for kids with life-threatening illnesses or grief counseling for families whose loved ones didn’t die in hospice care. Cary Sisti, Chief Clinical Operations Officer at Hospice and Palliative Care Buffalo, argued that the success of a service like this is measured not in profits or market share, but in trust in the faces of patients and families:

And Cara Pace, President and CEO of United Hospice, cited findings from the Journal for American Medicine that for-profit hospices provide worse service, less often:

Assemblymember Dr. Anna Kelles, a cosponsor of the bill, said at the press conference that good hospice care can sooth the trauma from a loved one’s death, mitigating mental health issues that affect families for generations. “We have documentation that shows if we continue to allow for profit entities to provide this level of care, they are going to put their profits first, second, third and fourth,” she said. “And maybe patients and families after that.”

Kelles shared her personal experience of a nonprofit hospice nurse taking care of her family after her father died:

New York already restricts hospices from operating under a corporation whose stock is owned by another corporation. And in her 2022 veto message of the previous version of the hospice bill, Hochul said she wanted the New York State Master Plan on Aging to evaluate for-profit hospices and make recommendations on regulation. But hospice advocates at the press conference said the state should skip to proactively banning new for-profits as soon as possible.

“Voters favor the governor signing this bill into law and protecting quality end of life care,” Chirco said, foreshadowing a statewide Siena poll, sponsored by the Hospice and Palliative Care Association, that has yet to be released. “The people of this state want hospice to remain community based, compassionate, and accountable, not driven by corporate profit.”