H.R. 10806
Medicare Home Health Payment Integrity and Protection Act of 2026
Sponsor: Claudia Tenney · 0 cosponsors
Official summary
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Text of the bill
I Home Health Program Integrity, Anti-Fraud, and Enrollment Reform
II Home Health Payment Reset and Data Integrity
Section 1895 of the Social Security Act (42 U.S.C. 1395fff), is amended by adding at the end the following new subsection:
(f) Conforming protection for benchmarks and value-Based programs
(1) In general. For 2027 and each subsequent year, in order to ensure that fraudulent and suspected fraudulent entities do not impact benchmarks or the application of any quality, value-based, or benchmarked adjustments for legitimate providers of home health services, the Secretary shall exclude or adjust for suspect claims when computing any such adjustments to payments to home health agencies under this section.
(2) Suspect claim defined. In this subsection, the term suspect claim means any claim for home health services submitted under this title that the Secretary determines contains unreliable data or data from a provider that may have engaged in fraud, waste, or abuse.
III Reports, Rulemaking, Program Integrity Funding, and Implementation