CMS proposes updates to home health payments for CY 2027, updates to provider enrollment and quality and value-based purchasing programs

The Centers for Medicare & Medicaid Services July 1 issued its calendar year 2027 proposed rule for the home health prospective payment system. The rule proposes a 2.4% update, which includes a 3.1% market basket update, reduced by a 1.0 percentage point cut for productivity, as well as an 0.3 percentage point increase related to outlier payments. In addition, the agency proposes a temporary cut of 3.0% that it states is necessary to achieve budget-neutral implementation of the Patient-driven Groupings Model.

CMS also proposes several policy changes related to provider enrollment provisions that it states would help reduce improper Medicare payments and protect beneficiaries. The provisions would affect any providers and suppliers participating in the Medicare program. For example, it would make all revocation of Medicare enrollment retroactive. It would also add several new grounds for revocation or denial of enrollment.

Finally, CMS proposes updates to reporting timelines for the home health quality reporting program to better align the program with the home health value-based purchasing program. The agency does not propose any changes to the VBP program.

CMS will accept comments on the proposed rule for 60 days following publication in the Federal Register. AHA members will receive a Regulatory Advisory with additional details on the rule in the coming days.

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