House Bill Pushes for Improved Fraud Measures & Home Health Reimbursement

WASHINGTON—A new bill has been introduced in Congress designed to improve home health payment rates and improve fraud detection.

Rep. Claudia Tenney introduced the House companion to the Medicare Home Health Payment Integrity and Protection Act of 2026 (SB 5250), sayng it would down on Medicare home health fraud, protect taxpayer dollars and ensure seniors can continue receiving quality care in their own homes.

The new act calls for strengthening provider screening, increasing inspections of high-risk agencies and providing additional tools to detect and prevent fraud. The legislation would also address potentially distorted Medicare payment rates and require the Centers for Mediare & Medicaid Services (CMS) to examine how fraudulent claims have affected reimbursements for legitimate home health providers.

“Fraudulent Medicare claims can distort the data used to calculate payments to home health agencies, potentially reducing reimbursements for legitimate providers across the country,” Tenney’s team announced in a news release. “These concerns have grown as suspicious billing patterns and an unusually high concentration of home health agencies in Los Angeles County have drawn scrutiny.”

The National Alliance for Care at Home applauded the move, saying it would stabilize the Medicare home health benefit by recalculating the Medicare home health payment for 2027.

“We are grateful to Representative Tenney for leading this important effort in the House,” said Jennifer Sheets, CEO of the Alliance. “Medicare home health payment should be built on reliable data, not on numbers distorted by fraud. This legislation fixes the flawed math behind years of compounding cuts and gives CMS the tools to stop bad actors before they receive federal funds. With bills now in both chambers, Congress has a clear path to protecting access to essential home health services.” 

The Alliance is urging House members to cosponsor the bill and called on Congress to move quickly to preserve access to care for their constituents and patients nationwide. The Alliance also asks CMS to rescind its proposed –3% temporary adjustment, which currently threatens to further constrain compliant providers and patient access to care where it’s wanted most: at home. 

The legislation builds on Tenney’s November 2025 letter urging CMS to investigate fraudulent billing practices, correct potentially distorted payment data, and prevent further harm to seniors and home health providers.

“Home health care is a lifeline for seniors who want to remain safe and independent in their own homes,” Tenney said. “Fraudulent providers are stealing taxpayer dollars, undermining Medicare, and putting legitimate home health agencies at risk. Seniors in Upstate and Western New York should not lose access to care because of fraudulent billing schemes across the country. Last November, I called on CMS to address this problem, and now I am joining Senator Collins to advance legislation that strengthens oversight, roots out fraud, and protects fair reimbursement for honest providers. We must protect Medicare for the seniors who depend on it and the taxpayers who fund it.”