On November 4th, CMS released the Calendar Year (CY) 2027 Home Health Prospective Payment System (HH PPS) final rule, which includes significant changes to Medicare provider enrollment and program integrity requirements. The rule expands CMS’ authority to deny or revoke Medicare enrollment, establishes retroactive effective dates for all enrollment revocations, and strengthens oversight of provider ownership changes. CMS also finalized clarifications to its enrollment moratorium policies, specifying that moratoria take effect when notices are filed for public inspection with the Federal Register rather than when formally published. The rule further clarifies that moratoria apply to certain changes in majority ownership, enrollment reactivations, and providers seeking to reenroll in Medicare.

Related to quality reporting, CMS clarified that skilled palliative care may be covered under the existing home health benefit and shortened the OASIS submission deadline from 135 to 45 days, potentially accelerating public quality reporting by three months.

In response to stakeholder concerns that broad enrollment restrictions can adversely affect legitimate providers and limit access to care, CMS maintained its proposed policies without modification, stating that broader recommendations regarding its moratorium authority were outside the scope of the rulemaking. Notably, the final rule doesn’t extend the existing nationwide home health agency enrollment moratorium, which is scheduled to expire November 13, 2026, absent further CMS action. The rule also finalizes an estimated 2.4% increase in aggregate Medicare home health payments for CY 2027.

Topics: CMS, Hospital at Home, Payment Policy