S. 5250
Medicare Home Health Payment Integrity and Protection Act of 2026
Sponsor: Susan M. Collins
1 cosponsor
Official summary
No official summary yet.
Text of the bill
I Home health program integrity, anti-fraud, and enrollment reform
II Home health payment reset and data integrity
Section 1895(b)(3)(D) of the Social Security Act (42 U.S.C. 1395fff(b)(3)(D)) is amended—
(1) in clause (i), by striking The Secretary and inserting Subject to clause (iv), the Secretary; and
(2) by adding at the end the following new clause:
(iv) Suspension of permanent and temporary adjustments for 2020 and subsequent years. Notwithstanding any other provision of law, for 2027 and subsequent years, for purposes of making any adjustment under this subparagraph, the Secretary shall not impose any adjustment under clause (ii) or (iii) to offset increases or decreases in estimated expenditures attributable to the difference in assumed versus actual behavioral changes due to the implementation of the Patient-Driven Groupings Model as described in the final rule entitled ‘Medicare and Medicaid Programs; CY 2020 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; and Home Infusion Therapy Requirements’ published in the Federal Register on November 9, 2019 (84 Fed. Reg. 60478).
III Reports, rulemaking, program integrity funding, and implementation