Hospice marketing: eligibility, referral rules and honest outreach to families

Families rarely shop for hospice the way they shop for other care. The conversation usually starts with a physician, a hospital discharge planner or a nursing facility, often when a family is exhausted and frightened. A hospice reaches them through those referral sources and through the information it puts in front of families when they go looking on their own.

That makes hospice marketing unusually sensitive. Most hospice care in the United States is paid by Medicare, the eligibility rules are specific, and federal oversight of how patients are recruited is close. This guide covers how to describe the benefit accurately, where outreach runs into the anti-kickback statute, what to avoid offering families, and what tends to work. It does not cover clinical decisions about who is eligible. For what staff may share with adult children, see marketing to family caregivers.

Describe the benefit in Medicare’s own words

The most useful page on a hospice website explains who hospice is for, and the safest way to write it is to follow Medicare.gov and link to it. Under 42 CFR 418.20, a person is eligible to elect the Medicare hospice benefit if they are entitled to Part A and certified as terminally ill under 418.22. Medicare.gov describes the conditions this way:

• The hospice doctor and the patient’s regular doctor, if they have one, certify that the patient is terminally ill, with a life expectancy of 6 months or less.
• The patient accepts comfort care (palliative care) instead of care to cure the illness.
• The patient signs a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness and related conditions.

Medicare.gov also explains points families often misunderstand, and your site can repeat them accurately: hospice care can continue after 6 months if the patient is recertified; the benefit runs in two 90-day benefit periods followed by an unlimited number of 60-day periods; the patient can stop hospice care at any time; and Medicare does not cover room and board when hospice care is given at home or in a nursing home. On cost, Medicare.gov says the patient pays nothing for covered hospice services, with a copayment of up to 5 dollars per prescription for outpatient drugs for pain and symptom management and possibly 5 percent of the Medicare-approved amount for inpatient respite care.

Keep the wording close to those sources and link to them. Phrases that blur the rules, such as suggesting hospice is free for anyone, or implying that eligibility is a formality, are both inaccurate and the kind of statement that draws scrutiny in this field.

If your organization also runs a PACE program, its marketing follows a separate rule set, including CMS and state review of materials before use and limits on unsolicited contact. See our guide to PACE program marketing.

Why oversight of hospice recruitment is close

OIG’s hospice page is worth reading before you plan any campaign. It describes years of audits, evaluations and investigations, and says that a hospice is paid every day a patient is in its care regardless of the quantity or quality of services provided, which OIG says creates financial incentives to minimize services and seek patients with uncomplicated needs. OIG lists open recommendations to CMS on quality, oversight and payment.

For marketing, the practical lesson is that anything suggesting patients are being enrolled for the hospice’s benefit rather than their own will be read in that light. Outreach should be about informing families and referral sources accurately, never about increasing census at any cost.

The anti-kickback statute in plain words

The federal anti-kickback statute, 42 U.S.C. 1320a-7b(b), makes it a felony to knowingly and willfully offer, pay, solicit or receive any remuneration, directly or indirectly, in cash or in kind, to induce or reward referrals of items or services payable by a federal health care program. It applies to both sides of a referral.

OIG’s Fraud and Abuse Laws page explains that remuneration includes anything of value and can take many forms besides cash, and that penalties can include fines, prison terms and exclusion from federal health care programs. The statute and OIG regulations include exceptions and safe harbors; OIG says an arrangement must fit squarely in a safe harbor and meet all of its requirements to be protected. One statutory exception covers amounts paid by an employer to a bona fide employee for providing covered items or services.

Where hospice outreach runs into the statute

These are the activities to review with counsel before they start:

1. Pay tied to admissions. Commissions or bonuses for community liaisons based on the number of Medicare patients they bring in. The employee exception covers bona fide employees; contractor arrangements need their own safe harbor analysis.
2. Gifts and meals for referral sources. Anything of value given to physicians, discharge planners or facility staff in connection with referrals.
3. Arrangements with nursing facilities. Payments, free staff or services provided to a facility whose residents you serve. Services have value just as cash does.
4. Paid referral or lead services. Buying patient referrals for federally payable care raises the same question as paying a person.
5. Recruiting patients directly. Door-to-door or community recruitment that pays or rewards anyone for signing patients up.

Educating referral sources about your services, service area, staffing, how fast you can admit and how to reach intake is ordinary marketing. The line is crossed when something of value is tied to referrals.

No inducements to patients and families

Under 42 U.S.C. 1320a-7a(a)(5), offering or transferring remuneration to a Medicare or state health care program beneficiary that the offeror knows or should know is likely to influence the choice of a particular provider can lead to civil monetary penalties. The statute’s definition of remuneration includes waivers of coinsurance and deductibles and items or services given free or for less than fair market value, with listed exceptions.

OIG’s 2016 policy statement interprets nominal value as no more than 15 dollars per item or 75 dollars in the aggregate per patient per year, and never cash or cash equivalents. In hospice marketing that rules out gift cards for choosing your hospice, extra non-covered services offered as an enticement, and similar offers. Describing what Medicare covers, in Medicare.gov’s words, is different from offering something extra to win the patient.

Respect patient choice

Medicare.gov says patients get hospice care from the hospice provider they choose. OIG’s patient sheet Know Your Rights, Take Action tells families to research their choices, interview prospective providers, use the Medicare comparison tool as one of their resources, and says a patient may change their designated hospice provider once in each election period. Your marketing should support those steps rather than work around them. Do not suggest that a hospital, facility or physician requires a family to use your hospice unless that is true and lawful, and do not pressure families to sign quickly.

Reviews, testimonials and your listing

Families read reviews from other families. The FTC rule on consumer reviews and testimonials, 16 CFR Part 465, prohibits fake reviews, and section 465.4 prohibits compensation or incentives conditioned on reviews expressing a particular sentiment. Ask every family for honest feedback, with nothing tied to a positive review, and never post a family’s story or photo without written permission. Remember that family members writing about a loved one’s care may share health details; a reply should not confirm or add to them.

Keep your Google Business Profile accurate: the real name, address or service area, hours and phone number. Our healthcare SEO page explains how listings and service pages work together for a provider that serves people at home.

What tends to work, inside the rules

1. A clear eligibility and cost page. Medicare.gov terms, linked, with the points families most often get wrong.
2. A what-to-expect page. The first visit, the care team, how to reach someone at night, and what happens if the patient’s condition changes.
3. Service area and admission speed. The counties you serve and how quickly you can usually admit after a referral.
4. A referral source summary. One page with intake phone, fax, hours and what you need for a referral, given without anything of value attached.
5. Answered phones at any hour. Families and facilities call when things change, often at night. Staff or an AI front desk that hands urgent calls to your on-call line keeps those calls from being lost.
6. Grief and caregiver resources. Bereavement support information helps families and referral sources understand what your team offers.
7. Tracking by source. Know which referral sources, searches and listings lead to admissions, as described on our medical lead generation page.

Home health agencies face many of the same rules; see our guide to home health agency marketing. For the wider picture of federal marketing rules, start with healthcare marketing rules.

Sources

• Medicare.gov: Hospice care
• 42 CFR 418.20: Eligibility requirements (hospice)
• 42 CFR 418.22: Certification of terminal illness
• HHS OIG: Hospice (last updated January 29, 2026)
• HHS OIG: Medicare Hospice Patients, Know Your Rights, Take Action
• 42 U.S.C. 1320a-7b: Criminal penalties for acts involving Federal health care programs (anti-kickback statute, subsection b)
• 42 U.S.C. 1320a-7a: Civil monetary penalties (beneficiary inducement, subsection a(5))
• HHS OIG: Fraud and Abuse Laws
• HHS OIG: Policy Statement Regarding Gifts of Nominal Value to Medicare and Medicaid Beneficiaries (December 7, 2016)
• 16 CFR Part 465: Use of consumer reviews and testimonials

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