According to the National Alliance for Hospice Access, when Congress initiated the hospice benefit in 1982, it placed a cap on services to control spending.

At the time, hospice care, for persons considered terminally ill, was uncharted territory.

But in 1998 when lawmakers updated the law, hospice advocates say Congress neglected to modify the cap on hospice providers. Area hospices met with representative of the alliance Thursday in Meridian.

"These independent hospices, like many others in the United States, are being asked to refund millions of dollars to Medicare that they were paid taking care of eligible hospice patients who have simply lived too long," said Lois Armstrong of the NAHA.

Some area hospices have been asked to repay millions of dollars to Medicare because the cap was exceeded.

"At the end of, I believe, 2004, we received a cap letter for fiscal year 2002-2003 for close to $2 million," said Amanda Knight of Hospice Direct. "To this day, our hospice in Union, Miss., actually owes Medicare $3.5 million. We started out our company debt-free. We refuse to discharge our patients who are still eligible for hospice."

The alliance contends the existing law, which has led to 62 percent of the state's hospices to be asked to refund $45 million, is flawed. The NAHA is pushing for corrective legislation to be introduced in Washington this year.