The Centers for Medicare and Medicaid Services (CMS) released the 2026 Home Health Proposed Rule (CMS-1828-P) on June 30, 2025. The comment period for the rule is currently set to expire on August 29, 2025. Homecare Homebase has compiled a brief summary of the information found in the proposed rule, along with links and helpful tools.
CMS 2025 Home Health Proposed Rule Resources
CMS 2026 Home Health Proposed Rule – At a Glance
The HCHB team has pulled together some quick highlights from the rule. Take a look at this summary and dive into the rule itself to learn more. Homecare Homebase encourages all home health agencies to write comment letters and add their voice to those advocating for the industry.
- Proposes an overall economic impact of -$1.135 billion (-6.4%). The $1.135 billion decrease in estimated payments reflects a 2.4% ($425 million increase) annual payment update, an estimated 3.7% decrease* that reflects the effects of the permanent adjustment ($655 million decrease), an estimated 4.6% decrease* that reflects the effects of the temporary adjustment ($815 million decrease), and an estimated 0.5% decrease that reflects the effects of an updated Fixed-Dollar Loss ratio ($90 million decrease).
- The estimated 3.7% decrease and the estimated 4.6% decrease related to the proposed permanent and temporary adjustments includes all payments, while the proposed -4.059% and -5.0% (respective) adjustments are only applied to the national, standardized 30-Day period payments and does not impact payments for 30-day periods which are LUPAs.
- Proposes updates to:
- LUPA thresholds
- Case-Mix Weights
- Functional Impairment Levels
- Comorbidity Adjustment Subgroups
- Wage Index
- FDL Ratio
- 30-Day Period Payment Rate ($1933.61)
- Per-Visit Payment Rates
- Proposes a revised face-to-face policy to allow broader practitioner involvement, including non-certifying physicians.
- Proposes updates to OASIS data collection rules to clarify they apply to all patients receiving skilled care, not just Medicare beneficiaries. CMS finalized the requirement to submit OASIS data for all patients, regardless of payer, starting July 2025.
- Proposes a shortened HHCAHPS survey beginning with the April 2026 sample month, with new questions added and outdated items removed. Proposes to adjust star ratings accordingly.
- Proposes changes to HHVBP scoring, measure set, and seeks feedback on adding injury and well-being metrics.
- Proposes to enhance fraud prevention in provider enrollment with more retroactive revocation grounds and oversight.
- Proposes to remove the COVID-19 vaccination measure and several SDOH assessment elements (Living Situation, 2 Food items, Utilities), reducing burden by over $17 million.
- Proposes to overhaul DMEPOS accreditation with annual re-accreditation, stricter Accrediting Organization (AO) rules, prior authorization exemptions for compliant suppliers, and rule changes to competitive bidding, including inflation adjustments and tribal exemptions.
- Requests feedback on the digital quality measurement (dQM) transition for HHAs and the adoption of health information technology (IT), and standards including Fast Healthcare Interoperability Resources (FHIR).
- Requests feedback on cognitive function, nutrition, well-being, and streamlining regulations/reducing regulatory burden.
HCHB is committed to helping our clients successfully navigate the complexities associated with regulatory and industry changes. Every year, the proposed and final rules for Hospice and Home Health are analyzed by The HCHB Product Management team to plan for needed changes to the software. In addition, HCHB Analytics users receive access to the Home Health Revenue Impact Model. This dashboard reflects the potential affects the proposed rule may have on a user’s organization.
