Policy & oversight
Bipartisan Senate Bill Would Reset Medicare Home Health Payment Rates and Add Anti-Fraud Requirements
A Senate bill introduced August 5 would set a new baseline Medicare home health episode payment rate for 2027, suspend recent payment reductions, and require background checks and liability insurance for agencies with elevated fraud risk. The bill awaits action in the Senate Finance Committee.
By the Goodsurance editorial teamAugust 24, 2026
Senator Susan Collins of Maine and Senator Marsha Blackburn of Tennessee introduced the Medicare Home Health Payment Integrity and Protection Act of 2026 (S.5250) on August 5, 2026. The bill has been referred to the Senate Finance Committee and does not have a scheduled hearing date.
The legislation addresses two distinct issues in Medicare home health.
A bipartisan Senate bill would reset Medicare home health payment rates and tighten fraud controls with mandatory background checks and liability insurance for high-risk agencies.
On payment, the bill would reset the standard prospective payment amount for a Medicare home health episode to 2,382 dollars and 87 cents for 2027 and suspend both the permanent behavioral assumption adjustment and temporary payment modifications that have trimmed agency reimbursements for several consecutive years. Home health providers and industry groups have argued those adjustment mechanisms have cut payments well below the actual cost of care.
On program integrity, the bill would require background checks on home health administrators before a new agency may enroll in Medicare, and mandate proof of liability insurance for agencies that CMS identifies as presenting a high fraud risk. CMS would receive additional resources to survey and investigate suspect providers and to conduct more frequent reviews of some agencies.
Home care industry groups praised the payment reset as long overdue. The bill must advance through the Senate Finance Committee before it can receive a floor vote.
In plain words
Two Republican senators introduced a bill on August 5 that would change how Medicare pays home health agencies and how it screens agencies for fraud.
On the payment side, the bill would set a new standard rate of 2,382 dollars and 87 cents per episode for 2027. It would also stop certain automatic payment reductions that have cut what home health agencies earn in recent years. Home health providers say those cuts have made it hard to stay financially stable.
On the fraud side, the bill would require agencies to pass background checks before they can join Medicare. Agencies that look like a higher fraud risk would also have to carry liability insurance. Medicare would get more money to inspect and investigate suspicious agencies.
The bill is now in the Senate Finance Committee and does not yet have a hearing date.
Understand the basics first
Source: Sen. Collins
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