Opportunity
Federal Register #2026-22750
CMS Finalizes Medicare Home Health Payment, Quality Reporting, and DMEPOS Policy Updates
Buyer
Centers for Medicare & Medicaid Services
Posted
November 09, 2026
Identifier
2026-22750
The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued a final rule updating Medicare home health and related DME policies; it is a regulatory notice, not a request to buy products or services. - Government buyer: HHS — CMS; no sub-agency office is identified. - Home health payment: For 2027, establishes a 3% temporary payment reduction (factor 0.9700), a 2.1% update for agencies reporting required quality data and a 0.1% update for those that do not, recalibrated payment measures, and an outlier FDL ratio of 0.29. - Quality reporting: Revises OASIS submission deadlines and transitions OASIS and HHCAHPS reporting periods to calendar-year reporting. - DMEPOS policies: Clarifies that an identical replacement item under the same HCPCS code does not, by itself, require a new face-to-face encounter; a replacement order and applicable documentation are still required. Expands coverage for qualifying external infusion pumps, associated home infusion drugs, and supplies. - Other policy changes: Strengthens provider and supplier enrollment safeguards and requires competitive-bidding suppliers to report the country of origin for lead items. - OEMs and vendors: No commercial OEMs, vendors, or specific products are named. No quantities or part numbers are requested.
Description
This final rule updates Medicare home health payment rates and related policies for calendar year 2027. It finalizes a temporary behavior adjustment, recalibrated case-mix weights, functional impairment levels, comorbidity subgroups, and low-utilization payment adjustment thresholds. It also finalizes changes to the Home Health Quality Reporting Program and addresses potential alignment with the expanded Home Health Value-Based Purchasing Model. Additional provisions clarify DMEPOS replacement-item encounter requirements, change provider and supplier enrollment requirements, implement a DME benefit expansion for infusion pumps and drugs, and address DMEPOS competitive bidding information collection.