S. 5250

Medicare Home Health Payment Integrity and Protection Act of 2026

Sponsor: Susan M. Collins

1 cosponsor
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I Home health program integrity, anti-fraud, and enrollment reform

II Home health payment reset and data integrity

Sec. 201. Reset of standard prospective payment amount

Reset of Standard Prospective Payment Amount.—Section 1895(b)(3)(A) of the Social Security Act (42 U.S.C. 1395fff(b)(3)(A)) is amended—

(1) in clause (i), in the matter preceding subclause (I), by striking Under such system and inserting Subject to clause (v), under such system;

(2) in clause (iii)—

(A) in the heading, by striking and subsequent years and inserting through 2026; and

(B) in subclause (I), by striking and subsequent years and inserting through 2026; and

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

Text this section adds to the law

(v) Basis for 2027 and subsequent years. With respect to payments for home health units of service furnished during 2027 or a subsequent year, the standard prospective payment amount shall be—

(I) for 2027, $2382.87; and

(II) for 2028 and each subsequent year, the amount determined under this clause for the preceding year, updated under subparagraph (B).

III Reports, rulemaking, program integrity funding, and implementation