Got a Medicare letter saying you started hospice? Here's what it means and what to do

Medicare is sending some people a letter titled "Starting Hospice" after a hospice tells Medicare they have chosen hospice care. The letter names the hospice. If that's right, you don't need to do anything. If you or your family never chose hospice, Medicare asks you to call 1-800-MEDICARE (1-800-633-4227) right away (CMS sample letter).

Key facts - Letter title: "IMPORTANT: [your name] Starting Hospice" - Sent after a hospice files a Notice of Election claim with Medicare - Where: California and Nevada, CMS's Kim Brandt said Oct. 28 - If it's correct: no action needed - If it's wrong: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048; say "questionable hospice election" - You can leave hospice at any time (42 CFR 418.28)

What does the letter say?

According to CMS's sample, it gives the date Medicare received a hospice "Notice of Election claim showing that you chose to start hospice care." It explains that hospice focuses on managing pain and symptoms "instead of treatments to cure your terminal illness." It lists the hospice's name and address. Then it gives two choices. If this is correct, "you don't need to do anything." If it is incorrect, call 1-800-MEDICARE "right away to report a 'questionable hospice election.'" TTY users can call 1-877-486-2048. CMS lists the sample on its fraud page.

The letter comes from Medicare, not from the hospice. It asks for a phone call, not money or personal details by mail.

Why is Medicare sending these letters?

To catch people signed up for hospice without knowing it. Speaking Oct. 28 at the National Alliance for Care at Home conference in Washington, CMS deputy administrator and chief operating officer Kimberly Brandt said CMS had recently started sending letters to Medicare beneficiaries enrolled in hospice in California and Nevada, in response to people being enrolled by fraudulent providers without their consent, HomeCare magazine reported. "Our No. 1 concern is making sure people know what they're being signed up for," she said.

Signing up for hospice matters because it changes coverage. A person who elects hospice gives up Medicare coverage of treatment meant to cure the terminal illness while the election lasts.

A hospice compliance software company, QAPIplus, told its clients in August that the letters were reaching patients in California, and that not every Notice of Election triggers one. CMS has not said how it chooses who gets a letter or how many it has sent.

Who is getting them?

People in California and Nevada whose hospice election Medicare has just received, based on Brandt's remarks. Getting a letter does not mean anyone suspects you, or your hospice, of anything. CMS's hospice fact sheet describes "targeted beneficiary messaging" as part of its anti-fraud work. Both states are among the six where CMS has added extra review of hospices, along with Arizona, Texas, Georgia and Ohio.

What should you do if you never chose hospice?

• Call 1-800-MEDICARE (1-800-633-4227) right away. Say you want to report a "questionable hospice election." TTY: 1-877-486-2048.
• Have the letter in hand. It shows the hospice's name and the date Medicare got the claim.
• Check your Medicare statements for hospice charges you don't recognize.
• You can also report suspected fraud to the HHS Office of Inspector General online or at 1-800-HHS-TIPS.

CMS says it now handles these complaints faster. Its January 2026 fact sheet says a rapid response team has reversed 584 hospice elections after complaints of inappropriate enrollment, and that it cut the disenrollment process from six months to under 12 days.

What if you did choose hospice but want to stop?

That's your right. Under federal rules, a person or their representative "may revoke the individual's election of hospice care at any time" (42 CFR 418.28). You do it by giving the hospice a signed statement with the date it takes effect. Your regular Medicare coverage for the illness then resumes, and you can choose hospice again later if you're eligible. Whether hospice is right for you is a decision for you, your family and your doctor; this article is not medical advice.

Is this connected to the hospice enrollment freeze?

It is part of the same push. CMS froze new Medicare enrollments of home health agencies and hospices nationwide in May, and must decide by about Nov. 13 whether to extend the freeze. Our moratorium story tracks that decision. Regulatory experts at the Alliance said the letter program could mean CMS keeps some hospice limits in place after the deadline, HomeCare reported. CMS has not said so. For how hospice differs from home health and home care, see our guide.

Sources

• CMS, Sample Beneficiary Hospice Notification (PDF)
• CMS, Crushing Fraud, Waste, & Abuse
• CMS, Hospice Fast Facts, January 2026 (PDF)
• 42 CFR 418.28, Revoking the election of hospice care
• HHS-OIG, Report Fraud
• HomeCare magazine, Oct. 29, 2026
• QAPIplus, Aug. 26, 2026

This item has not been clinically reviewed. It is general information, not medical, billing or legal advice.

Drafted with AI assistance from primary sources. Written and edited by the Home Health Brief newsroom under Monsaur Othman's editorial standards. Read how we use AI, our editorial policy and our corrections policy.