CMS finalizes changes to provider enrollment provisions, increases home health payments by 2.4% in CY 2027

The Centers for Medicare & Medicaid Services Nov. 4 released the calendar year 2027 home health prospective payment system final rule, which also includes significant provisions affecting provider enrollment for all Medicare provider types.

Specifically, CMS finalized Medicare provider enrollment changes that it says are aimed at reducing improper payments and addressing fraud, waste and abuse, with most provisions applying to all enrolled provider types. The changes make all enrollment revocations retroactive to the date noncompliance began. They also expand grounds for denying or revoking enrollment.
In addition, CMS finalized its authority to deny or revoke enrollment for hospices, home health agencies and durable medical equipment suppliers that fail to meet re-enrollment and survey/accreditation requirements following certain majority ownership changes. Additional provisions extend existing authorities for license and healthcare program suspensions or revocations to providers' owners and managing employees or organizations.

In addition, CMS finalized updates to the home health prospective payment system for CY 2027. This final rule increases payments by 2.4% in 2027 compared to 2026. This update includes a 3.1% market basket update, reduced by a 1.0% productivity adjustment and a 0.3% increase related to outlier payments. CMS will keep in place a 3.0% temporary reduction to the base payment rate to maintain budget neutrality due to implementation of the Patient Driven Grouping Model.

AHA members will receive a Regulatory Advisory with more details.