09/01/2026
To our BeLoved Hospice community & beyond -
Some of you may have seen or heard recent comments from Health & Human Services Secretary Robert F. Kennedy Jr. suggesting that hospice patients who remain on service for extended periods “never die,” that hospice generally means someone has only three months to live, and that a prolonged hospice stay is itself evidence of improper billing.
I want to address this directly because these statements dangerously misrepresent the Medicare hospice benefit and the patients we serve.
Hospice eligibility is not based on a promise that a patient will die within three months—or even within six months. Under federal law, a patient is eligible when a hospice physician determines, using clinical judgment and supporting documentation, that the patient has a prognosis of six months or less if the terminal illness runs its normal course. A prognosis is a medical estimate, not an expiration date.
Medicare expressly allows two initial 90-day benefit periods followed by an unlimited number of 60-day benefit periods. Patients may remain on hospice beyond six months—and even for several years—when they continue to meet eligibility requirements and are properly recertified. Beginning with the third benefit period, the patient must also receive a required face-to-face evaluation before each recertification.
Terminal illnesses do not follow identical or predictable timelines. People with dementia, neurological disease, cardiac disease, pulmonary disease, and other serious conditions may experience periods of decline, stabilization, or temporary improvement. Some patients also live longer precisely because hospice has successfully controlled symptoms, prevented avoidable hospitalizations, supported nutrition and medication management, and provided consistent interdisciplinary care.
Living longer than initially anticipated is not, by itself, evidence of fraud.
There is legitimate hospice fraud in this country - including the enrollment of individuals who were never terminally ill, enrollment without informed consent, identity theft, falsified documentation, and billing by entities that did not provide required services. Those practices harm patients, exploit Medicare, and damage the reputation of every ethical hospice. We fully support strong enforcement against fraudulent providers.
However, it is profoundly dangerous to confuse that fraud with appropriately certified patients who simply outlive a prognosis.
This rhetoric may frighten eligible patients and families away from hospice, make patients feel guilty for continuing to live, pressure clinicians toward premature discharge, and create the false impression that hospice professionals are waiting for—or financially dependent upon—a patient’s death.
Our responsibility at BeLoved Hospice remains unchanged. We will admit patients based on individualized clinical evidence, continually assess their condition, document their disease trajectory and related needs, and re-certify only when the hospice physician determines that the patient remains terminally ill under Medicare requirements. If a patient stabilizes or improves to the point that they no longer have a prognosis of six months or less, we will discharge them appropriately and support a safe transition. If they remain eligible, we will continue caring for them for as long as they need and qualify for that care.
Patients and families of BeLoved Hospice - please be assured that no patient has done anything wrong by living longer than expected. We are grateful that you all have gotten more time together than expected - it is in fact a gift.
Hospice is not about waiting for someone to die. It is about helping people live as fully, comfortably, safely, and meaningfully as possible while facing a terminal illness.
The careless words of a public official do not change the law, Medicare eligibility requirements, or the integrity of the work we do every day. We will continue providing thoughtful, ethical, compliant, and deeply compassionate care. I am extraordinarily proud of this team and will continue to advocate fiercely for our patients, families, and profession.
Sincerely,
Amber Perelgut, CEO
