November 5, 2026 Washington, DC — Statement from Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit providers of aging services, on the Calendar Year (CY) 2027 Home Health Prospective Payment System final rule, released November 4, 2026, by the Centers for Medicare and Medicaid Services (CMS):

“The CY 27 home health payment system final rule reflects a federal agency that is, unfortunately, out of touch with the realities providers must navigate today.

First, consider the cost of doing business. CMS’s decision to finalize a 3.0 percent temporary reduction to home health base rates is deeply concerning at a time when providers, including our nonprofit and mission-driven members, are struggling to sustain services and meet the growing needs of an aging population. While the agency’s estimated 2.4 percent aggregate payment increase is preferable to recent cuts, it does not address the financial pressures threatening access to care in the home.

The consequences are already evident: home health agencies across the country are reducing services or closing altogether due to inadequate reimbursement and rising operational costs. These are troubling signs of a system under increasing strain, putting access to care in the home at risk for older adults and others who depend on it.

Next, consider the operating environment. Providers need stable and predictable regulatory oversight that allows them to focus on delivering care while meeting their compliance obligations as participants in federal health care programs, including Medicare and Medicaid. That’s particularly important as CMS’ authority to exclude providers has recently expanded, and with this final rule, the agency is implementing significant changes to Medicare provider enrollment requirements that will impact all Medicare providers.

We recognize and appreciate CMS’ critical role in protecting beneficiaries and the trust fund from fraudulent actors by using the enrollment process as a way to keep unqualified and potentially fraudulent individuals and entities from entering and inappropriately billing Medicare.

Although much of the rule has, unfortunately, been finalized as proposed, we appreciate that some of the more problematic provisions we opposed are not included in the final rule, including the expansion of enrollment revocations and denials based on the Medicare debt and payment suspension of third parties over whom a provider exercises very little control.

We are deeply concerned that these final Medicare provider enrollment provisions will enhance the risks and uncertainty that our nonprofit and mission-driven members face as scrutiny of Medicare providers intensifies. CMS states that program integrity risk, not the finding of fraud, is the paramount goal of these new and much more expansive grounds for revocation and denial. With very few guardrails in place, this approach could unintentionally impact good providers.

As we noted in our August 31 comments and joint comment letter including 18 other national organizations, it is highly unusual for such extensive changes to the enrollment provisions to be included as part of a yearly payment rule, and we would have preferred that CMS address these changes in a separate rulemaking that is not constrained by calendar year cycle timeframes.

We will continue to work with the administration and Congress to focus more on targeted program integrity efforts and to ensure that quality providers are able to remain enrolled in Medicare and provide the care that their patients and residents desperately need.”