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Proposed Rule 2 Jul 2025 administrative practice and procedure, reporting and recordkeeping requirements, medicare, health professions, health facilities, investigations, rural areas, medicaid, fraud, healthcare compliance, medical devices, grant programs-health, diseases, drugs, biologics, payment rates, quality reporting, x-rays, home health, emergency medical services, durable medical equipment

🏥Medicare and Medicaid Proposed Rule on Home Health Payment Updates

This proposed rule would set forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this proposed rule 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.

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