The Centers for Medicare & Medicaid Services (CMS) has released the Calendar Year (CY) 2026 Home Health Prospective Payment System (HHPPS) Proposed Rule, which would cut Medicare payments to home health agencies by an estimated $1.135 billion — a net reduction of 6.4% compared to 2025. However, when accounting for gross reductions before inflationary updates, the total proposed cut climbs to 9.06%, making this the largest single-year reduction since the implementation of the Patient-Driven Groupings Model (PDGM) in 2020.

Key Proposed Payment Adjustments

• +2.4% market basket update
• −4.059% permanent behavioral adjustment to the base rate
• −5.0% temporary adjustment to recoup alleged overpayments from prior years
• −0.5% recalibration of the fixed-dollar loss (FDL) ratio for outlier payments

CMS asserts these changes are needed to account for discrepancies between projected and actual provider behavior under PDGM since 2020. However, HCAF is deeply concerned about the impact of these proposed cuts on Florida’s home health providers and the medically vulnerable patients they serve.

Additional Proposed Changes

• Expanded Face-to-Face Practitioner Eligibility: CMS proposes to align with the CARES Act by allowing non-physician practitioners (nurse practitioners, clinical nurse specialists, and physician assistants) to conduct Medicare-required face-to-face encounters, regardless of whether they are the certifying provider.
• Updated HHCAHPS® Survey: Implementation of a revised Home Health Consumer Assessment of Healthcare Providers and Systems survey, starting April 2026.
• OASIS Data Expansion: Agencies would be required to submit all-payer Outcome and Assessment Information Set (OASIS) data.
• Additional Changes: Proposed updates to the Home Health Quality Reporting Program (HHQRP) measures, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) accreditation rules, the competitive bidding program, and Medicare provider enrollment requirements.

Access CMS’s fact sheet for a detailed overview of the proposed rule here.

Free Webinar: How to Submit an Effective Comment to CMS

With so much at stake, it’s time to speak up. Join the National Alliance for Care at Home for a free national webinar offering a comprehensive breakdown of the proposed payment rule and its implications for agency operations, staffing, and patient access. You’ll receive expert guidance on how to write and submit a powerful, personalized comment to CMS, using real-world examples to illustrate your agency’s challenges.

• Date: Thursday, August 7, 2025
• Time: 3:00-4:00 PM ET
• Cost: Free

Whether you’re brand new to advocacy or a seasoned commenter, this session will provide practical tips and thought-starters to help you make a strong case before the Friday, August 29 deadline.

Click here to register for this free, must-attend webinar.

Join Us in Washington to Advocate for Home Care

Florida’s home care providers have a powerful story to tell — and there’s no better time or place to share it than in Washington, D.C., during the National Alliance for Care at Home Fall Advocacy Fly-In, taking place September 8-10.

Whether you represent a Medicare-certified agency, a Medicaid provider, or a private pay organization, this event is your opportunity to speak directly with federal lawmakers about the challenges you face and the critical care you provide. HCAF will arrange Capitol Hill meetings for all Florida attendees and offer group briefings and tailored talking points in advance, so you’ll be fully prepared to deliver a confident, compelling message on behalf of our state’s home care community.

Schedule At-A-Glance

• Monday, September 8: Optional Early Bird Welcome Reception
• Tuesday, September 9: Advocate Training & Hill Day Prep (Highly Recommended)
• Wednesday, September 10: Capitol Hill Meetings (Mandatory)

Click here for more information and registration instructions.

Lodging Information

While the Alliance has secured a group rate at the Hamilton Hotel ($359 per night plus taxes and fees), HCAF also recommends the Beacon Hotel & Corporate Quarters — located just 0.5 miles from the Hamilton — as a more affordable alternative. As of July 31, rates at the Beacon start around $241 per night (including taxes and fees) on Hotels.com. HCAF staff and many Florida attendees have stayed at the Beacon before and recommend it for its comfort, location, and value.

Click here to register for the fly-in and click here to book your stay at the Beacon.

Thank you for your continued support of HCAF. We are committed to protecting your agency, your staff, and the patients you serve. Let’s show up strong for Florida home care — and make our voices heard.