H.R. 4425 — Palliative Care and Hospice Education and Training Act

This section establishes Palliative Care and Hospice Education Programs by inserting new section 759A in Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.). The Secretary of Health and Human Services must award grants or contracts to eligible entities (i.e., those described in sections 799B(1), (3), or (4) and 801(2)) for programs supporting training of health professionals in palliative and hospice care, including traineeships and fellowships that emphasize patient and family engagement, integration with primary and specialty care, and collaboration with community partners to address gaps for individuals with serious or life-threatening illnesses. (Activities may include clinical and interprofessional training across disciplines and community-based programs for patients and caregivers; programs must not duplicate existing centers under this part or sections 753 or 865.) Awards prioritize coordination with other federal, state, or private programs and substantial benefits to rural or medically underserved areas, frontier health professional shortage areas, Indian Tribes or Tribal organizations, pediatric populations, or racial and ethnic minorities; additional priorities may include integration into primary care or other specialties and settings (e.g., hospitals, nursing facilities, home- and community-based care), faculty training, caregiver education, and outreach to areas with palliative and hospice workforce shortages. The section permits expansion of existing programs, including geriatric education centers under sections 753 or 865, to include palliative care training for non-geriatric populations. This section further authorizes grants and contracts to schools of medicine and osteopathic medicine, teaching hospitals, and graduate medical education programs to support palliative medicine physician training projects staffed by full-time physicians experienced in interprofessional team-based palliative medicine. Such projects must be based in Accreditation Council for Graduate Medical Education-accredited hospice and palliative medicine fellowships; provide training through rotations in settings such as consultation services, acute and extended care, ambulatory care, hospices, and home and community care; develop performance-based competency measures for trainees; and offer either 1-year retraining for faculty physicians or 1- or 2-year interprofessional team-based training programs.

This section expands nurse education, practice, and quality grants under section 831(b)(3) of the Public Health Service Act to include hospice and palliative nursing (i.e., adding it to the list of eligible areas such as coordinated care). The section also establishes a palliative care and hospice education and training grant program under new section 832 of the PHS Act (42 U.S.C. 296p et seq.), authorizing the Secretary to award grants or contracts to eligible entities—schools of nursing, health care facilities, certified nurse assistant programs, or partnerships thereof—to develop and implement interprofessional team-based palliative care training initiatives in health-related educational, hospital, hospice, home, or long-term care settings, in coordination with geriatric workforce programs under section 759A. Grant funds may be used to (1) train palliative care providers, (2) develop and disseminate palliative care curricula, (3) train palliative care faculty, or (4) provide continuing education to palliative care providers. Authorizes $5 million for each of FY2026 through 2030.

This section establishes a new section 904 in Part A of title IX of the Public Health Service Act authorizing the Director of the Agency for Healthcare Research and Quality to disseminate information on the benefits of palliative care—specialized care that provides relief from the symptoms and stress of serious or life-threatening illness (e.g., cancer, heart failure, neurodegenerative diseases such as dementia or ALS)—throughout the continuum of care for patients and families. If disseminated, the information must include (1) descriptions of palliative care as essential to quality care; (2) details on services provided by hospice and palliative care professionals, such as pain and symptom management, shared decision making, care coordination, psychosocial care, and spiritual care, which may begin at diagnosis alongside curative treatment to optimize quality of life; (3) the role of such professionals in team-based care; (4) evidence-based research on benefits; and (5) population-specific materials for Medicare and Medicaid beneficiaries, Veterans Health Administration patients, medically underserved populations (including pediatric, adolescent, young adult, and racial/ethnic minority patients), and relevant health professionals. Such information must be posted on the websites of the Department of Veterans Affairs, Centers for Medicare & Medicaid Services, and Administration on Aging. The Director must consult professional societies, hospice and palliative care stakeholders, and patient advocates on planning, development of materials, and defining "serious or life-threatening illness."

This section prohibits the use of funds made available under this Act (or an amendment made by this Act) from being used to provide, promote, or provide training with regard to any item or service for which federal funding is prohibited under the Assisted Suicide Funding Restriction Act of 1997 (42 U.S.C. 14402)—a law barring Medicare, Medicaid, and certain other federal health programs from funding assisted suicide, euthanasia, or mercy killing (with exceptions for pain alleviation and withholding treatment). It further clarifies that, as used in this Act, palliative care and hospice shall not be furnished for the purpose of causing, or assisting in causing, a patient's death.

This section adds a new section 409K to direct the Secretary of Health and Human Services, or designee, to develop and implement a strategy across the institutes and centers of the National Institutes of Health (NIH) to expand and intensify research programs in palliative care, addressing quality of care and quality of life for patients with serious or life-threatening illnesses (e.g., cancer; heart, kidney, liver, lung, and infectious diseases; neurodegenerative diseases such as dementia, Parkinson’s disease, or amyotrophic lateral sclerosis). It further amends NIH biennial reporting requirements under Section 402A(c)(2)(B) to include, beginning January 1, 2026, research activities related to palliative care.