Sponsors (22)
The bill avoids payment cuts and revenue disruption for home health beneficiaries and providers in 2026–2027 by adjusting rates upward, but does so at the cost of higher Medicare spending and the risk of masking cost trends or preserving inefficiencies that could complicate future rate-setting.
Medicare beneficiaries receiving home health care will not face payment-rate-driven cuts in 2026–2027 because rates are adjusted upward to offset the proposed reductions.
Home health agencies and providers gain predictable payment rates for 2026–2027, avoiding sudden revenue reductions tied to the proposed negative adjustments.
CMS can implement the offset quickly via program instruction, reducing administrative delay in preserving payment levels.
Taxpayers and Medicare trust funds face higher program spending in 2026–2027 because the bill prevents the proposed rate reductions.
Blocking the proposed downward adjustments may preserve inefficiencies or overpayments that the 2025 rule aimed to correct, risking continued excess spending.
Excluding these additional payments from expenditure calculations could complicate future rate-setting and mask underlying cost trends, reducing transparency for policymakers and stakeholders.
Based on analysis of 2 sections of legislative text.
Prevents two proposed cuts to the 2026 Medicare home health payment rate by requiring offsets in 2026–2027 and sets those years' rates based on the 2025 rate with those offsets applied.
Introduced September 4, 2025 by Kevin Hern · Last progress September 4, 2025
Prevents two proposed cuts to the Medicare home health prospective payment rates for calendar year 2026 from taking effect and requires positive adjustments in 2026 and 2027 to fully offset those reductions. It also sets the 2026 and 2027 national standardized 30-day payment rates based on the 2025 rate (with the offsets applied), limits certain automatic adjustments for those years, allows CMS to implement the offsets by program instruction, and instructs CMS not to count the added payments when calculating actual expenditures that could trigger further offsets. The change is temporary and narrowly focused on payment rates for 2026–2027; it does not change the underlying payment methodology and includes a clause saying Congress is not approving or disapproving a prior CMS methodology rulemaking.