With just days left in June, home health industry stakeholders are awaiting news on proposed payment updates for 2026. In recent years, the Home Health Prospective Payment System proposed rule has typically arrived in the final days of June.
 
Beyond news on payment rates for the next calendar year, the proposed rule typically includes updates to PDGM case-mix weights, comorbidity subgroups and functional impairment levels.
 
In April, CMS announced plans for a 2.4% payment update for hospices beginning in October. While home health providers can hope for a similar adjustment, the past few years have included a crippling proposal for payment cuts related to behavioral adjustments under PDGM.
 
It’s unclear if there will be any other policy changes announced in the proposed rule. Other potential updates include:
  • RFI on Trump Admin priorities. The proposed rule for hospices released in April included three notable requests for information on quality measures related to Trump administration priorities. This included interoperability, patient well-being and nutrition.
  • Shorter HHCAHPS. Through the pre-rulemaking process, CMS shared some details for a shorter HHCAHPS survey and related changes to quality measures. This would follow the shorter CAHPS Hospice survey that is currently being rolled out. Unlike the hospice update, the HHCAHPS is not expected to have a web-based version.
  • Comprehensive assessment allowances. Last summer, CMS sought comments on whether to allow rehabilitative therapists to conduct the initial and comprehensive assessment for cases with therapy and nursing services ordered. This is a move long sought by the industry, primarily due to staffing shortages, but CMS made no move to change existing restrictions with the final rule last fall.
Last year, the rule was released June 26. For the previous years, proposed rules were released on:
  • 2023: June 30
  • 2022: June 17
  • 2021: June 28
  • 2020: June 25
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