Volume 26.02
On July 1, 2026, the Centers for Medicare & Medicaid Services (“CMS”), issued a proposed rule to be published in the Federal Register on July 6, 2026. The proposed rule updates payment policies for home health agencies and announces other policy changes. The proposed rule is available here. The Fact Sheet is available here.
The proposed rule would update Medicare home health payment rates for CY 2027. At the same time, CMS is proposing policies intended to strengthen oversight and reduce fraud, waste, and abuse. CMS is also proposing targeted payment updates that support access to care for beneficiaries who rely on home health services. CMS estimates total Medicare payments to home health agencies would increase by approximately 2.4%, or $420 million, compared to CY 2026.
The Proposed Rule includes:
Temporary PDGM Adjustment – CMS proposed continuing a temporary three percent (3%) adjustment to the 30-day payment amount. CMS is not proposing any new permanent adjustment for 2027.
Community-Based Palliative Care – CMS proposed the intent to encourage access to skilled community-based palliative care under existing home health benefits, distinguishing it from the hospice care benefit.
Quality Reporting (“QRP”) Revisions – The proposed rule would shorten the deadline for submission of OASIS assessment data from 4.5 months to 45 days.
Medicare Provider Enrollment & Fraud – The proposed rule provides Medicare-wide program integrity rules, including making all Medicare enrollment revocations retroactive to the date of date of the noncompliance. Additionally, agencies undergoing specific changes in majority ownership must enroll as new providers.
Medicare Provider Enrollment
Retroactive Revocations – Under current regulations, certain Medicare enrollment revocations become effective thirty (30) days after the date that CMS or the CMS contractor mails the notice of the revocation to the affected provider or supplier (hereafter “provider”). However, other revocations take effect retroactively to the date the provider’s noncompliance began. CMS is proposing to make all revocation grounds retroactive.
Adding or Expanding Bases for Revocation or Denial – CMS is proposing to add several new grounds for revocation or denial of enrollment and to expand some of the existing grounds. Among these proposals are the following:
- Change in Majority Ownership – Hospices, HHAs, and suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) must reenroll in Medicare as a new provider and undergo a survey/accreditation if they experience certain changes in majority ownership. CMS proposes to deny or revoke enrollment if this requirement is violated.
- Program or License Suspension/Termination – CMS currently may deny or revoke enrollment if a provider: (1) has a suspended/revoked license in another state; or (2) is suspended/revoked from Medicaid or another federal healthcare program. The agency proposes expanding this to include similar suspensions/revocations involving the provider’s owners or managing employees/organizations.
LAS VEGAS PROGRAM FILLING RAPIDLY
The 2026 “Hospice Financial & Compliance Management Conference” is now available for registration. Early registration has been great. Space at this program is limited to enhance the quality of the program and networking opportunities for the attendees. The two-day program is being held at the Paris Las Vegas on October 1-2, 2026.
As always, this annual program offers the most extensive hospice financial coverage available. The integration of finance and compliance is critical to survival and success of any hospice. This year compliance and the associated financial risks are critical. Initial information and registration information is available here. Discounted room rates are available here or by calling (877) 603-4389. Make certain to inform Paris Las Vegas that you are attending The Health Group program. See you in Las Vegas.
OTHER EBLASTS AVAILABLE
The Health Group, LLC provides other emails to healthcare providers. The Hospice Alert provides specific information for hospice providers, and the Healthcare Alert provides general information for all healthcare providers. If you are not receiving these and want to be added to the email list, please let us know via email to contact@healthgroup.com.