CMS-1828-P

CMS issued a proposed rule [CMS-1828-P] that proposes routine updates to the Medicare home health payment rates; proposes permanent and temporary behavior adjustments and proposes to recalibrate the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. Lastly, this proposed rule proposes policy changes to the face-to-face encounter policy. It also proposes changes to the Home Health Quality Reporting Program (HH QRP) and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. In addition, it would update the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Lastly it proposes: a technical change to the HH conditions of participation; updates to DMEPOS supplier conditions of payment; updates to provider and supplier enrollment requirements; and changes to DMEPOS accreditation requirements.

The CY 2026 HH PPS proposed rule with comment went on display at the Office of the Federal Register’s Public Inspection Desk on June 30, 2025 and will be available until the regulation is published on July 2, 2025. The comment due date is August 29, 2025. See CMS-1828-P in the “Related Links” section below.