H.R. 10806

Medicare Home Health Payment Integrity and Protection Act of 2026

Sponsor: Claudia Tenney · 0 cosponsors

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I Home Health Program Integrity, Anti-Fraud, and Enrollment Reform

Sec. 101. Enhanced enrollment screening for home health agencies

Section 1866(j)(2) of the Social Security Act (42 U.S.C. cc(j)(2)) is amended—

(1) in subparagraph (B)—

(A) in clause (i), by striking and at the end;

(B) in clause (ii)(V), by striking the period at the end and inserting ; and; and

(C) by adding at the end the following new clause:

Text this section adds to the law

(iii) beginning 1 year after the date of enactment of this clause, in the case of a home health agency applying for enrollment under this title that is at an extreme risk of fraud (as determined under subparagraph (G)), shall, in addition to any other screening required under this subparagraph—

(I) in the case where fingerprinting is included in such screening with respect to home health agencies pursuant to clause (ii)(II), require fingerprinting of the administrator of such home health agency; and

(II) require obtaining evidence that such home health agency has a comprehensive liability insurance policy, as determined by the Secretary.

; and

(2) by adding at the end the following new subparagraph:

Text this section adds to the law

(G) Home health agencies at extreme risk of fraud

(i) In general. Beginning 1 year after the date of enactment of this subparagraph, for purposes of subparagraph (B)(iii), the Secretary shall determine whether a home health agency is at an extreme risk of fraud based on—

(I) the determination made under clause (ii); and

(II) such other factors as the Secretary may specify.

(ii) Determination of high-risk areas. For purposes of clause (i), the Secretary shall determine whether a home health agency is located in a State or county with respect to which, during the most recent year for which data is available, the total number of home health agencies located in such State or county significantly exceeded the total number of such agencies located in such State or county during the preceding year.

II Home Health Payment Reset and Data Integrity

III Reports, Rulemaking, Program Integrity Funding, and Implementation