From the December 2, 2025, meeting of the Home Health Network, this presentation reviews the Calendar Year (CY) 2026 Home Health Prospective Payment System (HH PPS) Final Rule. This members-only resource is available in our Resource Library, here.

The Centers for Medicare and Medicaid Services (CMS) on November 28, 2025 released the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule. The CY 2026 updated rates include the final CY 2026 HH payment update of an estimated 2.4% increase ($405 million increase), which is offset by an estimated 0.9% decrease that reflects the final permanent adjustment ($150 million decrease), an estimated 2.7% decrease that reflects the final temporary adjustment ($460 million decrease), and an estimated 0.1% decrease that reflects the updated fixed-dollar loss (FDL) ratio for outlier payments ($15 million decrease). CMS estimates that Medicare payments to HHAs in CY 2026 will decrease in the aggregate by an estimated 1.3%, or $220 million, compared to CY 2025, based on the finalized policies. More here.

The CY2026 Home Health Final Rule moved to the Office of Management and Budget (OMB) on October 24, 2025, marking the near end of this rulemaking cycle prior to the rule’s publication in the federal register with payment (such as the proposed 9% reductions) and other elements made permanent. This year’s process has been particularly drawn out. While it is not quite the latest a final rule has ever been published yet (that was November 22, in the 2013 rulemaking cycle), this is the latest move to OMB in 20 years. It is unclear how long OMB will need to review the rule given the significant concerns raised by the home health sector as well as other controversial items in the rule around the durable medical equipment competitive bidding program. 

In an October 23, 2025 coalition letter to congressional leadership, LeadingAge national and 21 State Partners, along with the Alliance for Care at Home, urge action to prevent the Centers for Medicare and Medicaid Services (CMS) from finalizing the proposed 2026 Medicare home health payment cuts, which pose a serious threat to the health and safety of Medicare beneficiaries, and also address flaws in the payment system. Read the letter here.

Representatives Sarah McBride (D-DE) and Jefferson Van Drew (R-NJ) in an October 8, 2025 letter to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz, express “deep concerns” with the proposed changes to the Medicare home health 30-day payment rates and urge the agency to a pause on implementation of any further reductions to payment rates and revisit their approach to rate calculations. More here.

The bipartisan Medicare Beneficiary Home Health Access Protection Act of 2025 (HR 5142) was introduced on September 4, 2025, by Reps. Kevin Hern (R-OK) and Terri Sewell (D-AL). The bill would require the Secretary for Health and Human Services to issue a special rule for calendar years (CY) 2026 and 2027 to provide a positive adjustment to the standard Medicare Fee-for-Service (FFS) payment and fully offset the large cuts proposed for CY26 and any future behavioral adjustments for CY27. Find more details here, along with comments from LeadingAge President and CEO Katie Smith Sloan.

In comments submitted to the Centers for Medicare and Medicaid Services (CMS) responding the CY2026 Home Health Proposed Payment Rule, LeadingAge expressed grave concerns over the impact of the deep reductions in Medicare fee for service (FFS) payment rates the agency put forth in its rule–including reduced access to home health care. In addition to urging CMS to halt the devastating 9 percent payment cuts, we also expressed the urgent need to correct flawed methodologies in the budget neutrality adjustments, and to address structural issues in the Home Health Value-based Purchasing (HHVBP) program to protect beneficiaries–many of whom have complex needs–and the providers who deliver care. Read our press release here.

Following our July 28 release (scroll down) of two co-branded explainers for use in advocacy work, LeadingAge has prepared a “Tips for Commenting” guide for home health members to structure their own agency’s response to the proposed rule including language around the nonprofit difference. In addition, we’ve created an easy-to-use Action Alert for home health staff, board members, and aging services provider partners to use to submit comments in opposition to the proposed rule’s -9% cuts. Finally, because data helps support LeadingAge advocacy, please take our survey, which is open until Friday, August 15. Answer a few questions about the impact of a 9% payment decrease and the financial realities you are navigating. The information will inform our advocacy response. Access the survey here.

The proposed cut to payment rates for Medicare Fee for Service (FFS) payment rates for home health services included in the Centers for Medicare and Medicaid Services (CMS) Calendar Year (CY) 2026 Home Health Payment System Rate Update is deep: 9%. The impact, when combined with the 8.8% payment reductions the agency has imposed since CY2023, will be significant to all providers of home health care–but nonprofit providers are particularly at risk. We’ve developed a multi-pronged advocacy strategy to fight against the cuts. Find two assets (Nonprofit Talking Points for LeadingAge members and the Protect Home Health explainer, created in partnership with the National Alliance for Care at Home) for use in these efforts here.

Following the Centers for Medicare and Medicaid Services’ (CMS) June 30 release of the proposed CY2026 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements Proposed Rule, we provide a summary and analysis of the rule’s major components here.

The Centers for Medicare and Medicaid Services (CMS) on June 30 released the CY2026 Home Health Proposed Rule that will make an aggregate -6.4% cut to the base payment. CMS is proposing a -4.059 percent permanent adjustment to the CY2026 home health base payment rate. Additionally, the temporary adjustment which has been accruing over the last several years now stands at $5.3 billion. If this were to be taken back in a single year it would be a 35% reduction to the base payment, which CMS considers too much of a burden. Therefore, the agency is proposing to apply the first temporary adjustment in CY2026 with an additional -5.0 percent on top of the proposed -4.059 permanent adjustment. The minuscule market basket update for CY2026 is proposed at only 3.2 percent. More here.

“The 6.4% cut to the current rate that the Centers for Medicare and Medicaid Services (CMS) proposes for home health providers will, if implemented, be a death knell for many quality agencies,” said LeadingAge president and CEO Katie Smith Sloan in a statement following the rule’s June 30 release.

Senators Susan Collins (R-ME) and Marsha Blackburn (R-TN) in June 2025 sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz raising concerns about the future of the home health benefit and asking CMS to use its statutory authority to pause any planned cuts in the CY2026 Home Health Proposed Rule.