Home health operators and stakeholders have publicly criticised the proposal for the 2026 calendar year of Medicare and Medicaid Services (CMS) since its June announcement. Currently, stakeholders are submitting official comments as the proposed public comment period for Home Health Regulations is approaching its end.
The public comment period ends at the end of Eastern Time on Friday, August 29th. At the time of the publication of this story, over 10,000 comments have been submitted.
Critics of the proposed rule say it amounts to a 9% payment cut to the 30-day base payment rate, limiting access to care, hindering home health providers' investment in technology and the ability to strain their home health providers to referral partners.
Commenters warn that home health services are already operating at slim margins and that the proposed reductions are disastrous for patients, agencies and Medicare itself.
Home Health News highlighted the outstanding statement from six letters to CMS.
***
The proposed reduction will result in an estimated $1.13 billion reduction in home health care payments compared to 2025, both permanent and temporary adjustments. …If beneficiaries do not have access to home care, Medicare often pays higher costs as a result of increased emergency department visits, preventable hospital readmissions, and the need for more expensive institutional care. Such outcomes are unacceptable because these capabilities threaten the patient's capabilities in the environment they prefer most, namely home threatening and place unnecessary financial burden on Medicare programs.
– National Care Alliance at Home
***
Home care is essential for aging services, especially for nonprofit providers who serve vulnerable elderly people. The Centers for Medicare and Medicaid Services (CMS) proposes a 9% reduction in CY2026, in addition to an 8.8% reduction since CY2023, threatening the survival of mission-driven providers. Access for seniors and families is rapidly declining due to agency closures, with fewer beneficiaries receiving care, leading to delayed discharge and increased medical costs. We urge CMS to reject these cuts and fix any defects in the payment system that will negatively affect nonprofits and mission-driven member institutions. These and other actions outlined in our comments are essential to enable these providers to continue to serve complex patients and reinvest in their communities.
– Katie Smith Sloan, president and CEO of the Association of Nonprofit Providers of Aging Services, including Home Health Care
***
The (American Hospital Association) is very concerned about the ongoing access challenges for beneficiaries in need of HH care and the possibility that the proposed update of the CMS could lead to further disruption. HH institutions are essential for the recovery of Medicare beneficiaries and are partnering with acute care and other hospitals to ensure patients receive the right care in the most appropriate environment. Hospitals rely on HH institutions to avoid patient discharge safely and timely discharge and extended hospital stays. Financial challenges have created tensions in HH operations and other post-acute care providers, creating ripple effects across ongoing care, including acute and acute hospitals. Nevertheless, CMS suggests renewing payment rates for inadequate HH agencies and even more false behavioral adjustments. We review these proposals and encourage HH agencies to take steps to enable them to receive payment renewals that are consistent with their financial reality and to continue to provide high quality care to Medicare beneficiaries.
– American Hospital Association
***
AXXESS is deeply concerned about a significant decline in the CY 2026 proposal rules. We understand CMS' responsibility to ensure payment accuracy and budget neutrality, but the scale of these reductions is felt throughout the US health delivery ecosystem. Home healthcare providers are already operating at a thin margin of razors considering the advantages of Medicare and the total case mix and significant losses that care for Medicaid patients. Reducing refunds further limits the ability of providers to hire and retain staff, provide competitive wages, and maintain services in rural and underserved communities. Additionally, changes to CMS policy directly impact our ability to invest in increasingly needed technology enhancements. This ranges from digital quality measurements to FHIR-based interoperability and OASIS reports on all wages.
– axxes
***
Wellsky works closely with clinicians and healthcare leaders who are dedicated to providing compliant and effective care. These providers are essential to help Medicare beneficiaries stay home, even when there are complex care needs. Data-based, risk-fitting home care contributes extraordinary value to Medicare programs by reducing avoidable hospitalizations and institutionalization costs. Therefore, we would like to express our sincere concern about the reductions proposed by CMS for our home health program and its providers. The proposed payment adjustments will have a devastating impact on Medicare beneficiaries' access to home health services. This is an important health care that has been proven to provide high quality care at low cost.
– Welsky
***
CMS continues to make final decisions by proposing a reduction in payment rates each year. These reductions are based on a methodology that makes legitimate providers financially unstable and incorporates manipulated claims data. If this trend is not corrected, it will permanently erode the benefits of home care as originally intended under Medicare, leading to desert and patient harm. …The honest provider is closing the door. The patient is suffering. CMS has the authority to act. The choice is clear. The time for action is now. CMS encourages you to act quickly to stabilize your home hygiene payment system. The integrity of Medicare programs and the well-being of millions of in-home patients depend on it.
– Leading executives, National Care Alliance at Home, Accentcare, Addus Homecare (NASDAQ: ADUS), Adoration Home Health and Hospice, Aveanna Healthcare, Bayada Home Health Care, Elara Caring, Enhabit Home Health and Hospice (Nyse: Ehab), Gentiva, Nasdaint Group, Lifecare health, visitivar nurse health systems and VNS health
