“The Medicare Home Health Payment Integrity and Protection Act of 2026,” introduced August 5, 2026, by Sen. Susan Collins (R-ME), would implement targeted program integrity provisions in home health that mirror those in Rep. Beth Van Duyne’s (R-TX) HR 8883 “Protecting Seniors and Stopping Fraudsters Act.”

S 5250, which LeadingAge supports, would also eliminate all permanent and temporary adjustments to the standard prospective payment rate, resulting in a much-needed reset of the home health rate after years of cuts.

Both changes are critical: the program integrity provisions are targeted as opposed to broad based like those proposed in the CY2027 home health rule.

“Access to health care and services is an important benefit today, as America grows older—by 2050, adults age 65 and older will increase from 17% to nearly 25% of the population. What’s more, care at home is what people prefer and it also delivers strong patient satisfaction and quality outcomes. Yet the valuable Medicare home health benefit is under threat. Senator Collins’ bill rightly seeks to rectify two contributors to that unfortunate situation: bad actors seeking to exploit the program, and a payment methodology that has produced years of reductions due to a flawed methodology,” said Katie Smith Sloan, president and CEO, LeadingAge, in a statement.

On the payment side, the Centers for Medicare and Medicaid Services’ (CMS) patient-driven groupings model (PDGM), in place since 2020, applies permanent and temporary payment adjustments, as required by Congress, premised on isolating “assumed versus actual” behavior change.

The widely recognized problem is that in practice, neither CMS nor any other stakeholder, has managed to isolate the specific behavior due to PDGM from other factors that have also changed over the same time frame: patient acuity, referral patterns, staffing markets, the shift in post-acute utilization, potential fraud, and the lasting effects of the public health emergency.

Rather than continue use of the problematic behavioral adjustments methodology, Senator Collins’ bill proposes to set a rate that reflects the patients agencies actually serve, and pause further assumption-driven adjustments. Home health providers need this relief, and the older adults and families who depend on care at home need the stability and access sensible rate-setting would deliver.

Senator Collins’ press release can be found here.