H.R. 10806
Medicare Home Health Payment Integrity and Protection Act of 2026
Summary:
• The bill strengthens Medicare home health agency enrollment screening and oversight, including fingerprinting of administrators, insurance requirements, and increased survey frequency for newly enrolled or high-risk agencies
• The bill resets Medicare home health payment calculations starting in 2027 using data from 2020 as a baseline, excluding claims associated with fraud, waste, abuse, or COVID-19 distortions, and suspends certain behavioral adjustment offsets tied to the Patient-Driven Groupings Model
• The bill appropriates $550 million for fiscal years 2027–2031 to fund program integrity, enforcement, and state survey activities related to home health fraud
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• The bill resets Medicare home health payment calculations starting in 2027 using data from 2020 as a baseline, excluding claims associated with fraud, waste, abuse, or COVID-19 distortions, and suspends certain behavioral adjustment offsets tied to the Patient-Driven Groupings Model
• The bill appropriates $550 million for fiscal years 2027–2031 to fund program integrity, enforcement, and state survey activities related to home health fraud
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