Agency issues proposed payment rule that would reduce payments $1.135B in 2026

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on Monday, June 30, that would permanently reduce home health payment rates by 4.059% in 2026 and add a temporary 5% clawback as well.

Altogether, with a range of increases and decreases, CMS estimates that Medicare payments to home health agencies would drop 6.4% or $1.135 billion compared to 2025. 

CCG clients will now be able to benefit from Cliniqon’s home health & hospice coding & review experts

North Haven, Connecticut—To help home health and hospice organizations meet compliance standards and comply with the Center for Medicare and Medicaid Services’ Patient-Driven Groupings Model (PDGM) and Home Health Value-Based Purchasing (HHVBP), Corcoran Consulting Group (CCG) has partnered with Cliniqon, a tech-enabled company that specializes in home health and hospice coding and quality assurance, following all protocols and regulatory standards set by the Centers for Medicare and Medicaid

WASHINGTON—The Centers for Medicare & Medicaid’s (CMS) proposed rate reductions for home health could be devastating for agencies if they are codified, said Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). Even worse, CMS has left a door open to demand some $3 billion in clawbacks for prior years of what it interprets as over-payments.  

WASHINGTON, D.C. (November 1, 2022)—The Centers for Medicare & Medicaid Services (CMS) released its final rule for Medicare home health payments on October 31, settling on a rate reduction of 3.925% for 2023 with additional cuts to come in 2024. That's less than the 7.69% cut initially proposed by the agency for 2023, but still a blow to providers, according to industry advocates.



WASHINGTON, D.C. (September 24, 2021)—The Medicare Payment Advisory Commission (MedPAC) met to discuss the development of a mandated report assessing the impact of the shift to the Patient Driven Groupings Model (PDGM) payment model for Medicare home health, and in particular the 30-day episode and the removal of therapy utilization in payment determinations.


WASHINGTON, D.C. (November 6, 2020)—The Centers for Medicare & Medicaid Services (CMS) has issued another revision to change request 11855—Penalty for Delayed Request for Anticipated Payment (RAP) Submission—Implementation. The Change Request (CR) revision added remittance advice message information related to the No Pay RAP penalty.

Home health agencies (HHAs) should note that Medicare Administrative Contractors (MACs) will: