Medicare Hospice Reform and Savings Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to revise payments and coverage for hospice care under the Medicare program.
Prescribes conditions for recovery by the Secretary of Health and Human Services (HHS) of repayment demands from a hospice program for any accounting year during the four-year period ending on October 31, 2009.
Requires the Secretary to issue evidence-based national coverage determinations for life expectancies covering at least each of those terminal medical diagnoses currently covered by Local Coverage Determinations promulgated by Medicare's fiscal intermediaries.
Directs the Secretary to restore the application (and reduce the phase out) of the budget neutrality adjustment factor in the Medicare hospice wage index for FY2010-FY2013 in a manner that will result in an aggregate increase in Medicare expenditures equivalent to the aggregate reductions in expenditures resulting from the issuance of the national coverage determinations.