News: CMS finalizes changes to provider enrollment provisions, increases home health payments

CMS released the calendar year 2027 home health prospective payment system (PPS) final rule, which includes significant provisions affecting provider enrollment for all Medicare provider types.

CMS finalized Medicare provider enrollment changes that it says are aimed at reducing improper payments and addressing fraud, waste, and abuse. Most provisions apply to all enrolled provider types. The changes make all enrollment revocations retroactive to the date noncompliance began. They also expand grounds for denying or revoking enrollment.

CMS also finalized its authority to deny or revoke enrollment for hospices, home health agencies, and durable medical equipment suppliers that fail to meet reenrollment and survey/accreditation requirements following certain majority ownership changes. Additional provisions extend existing authorities for license and healthcare program suspensions or revocations to providers’ owners and managing employees or organizations. 

The final rule increases payments by 2.4% in 2027 compared to 2026. This update includes a 3.1% market basket update, reduced by a 1.0% productivity adjustment and a 0.3% increase related to outlier payments. CMS will keep in place a 3.0% temporary reduction to the base payment rate to maintain budget neutrality due to implementation of the Patient Driven Grouping Model.

Editor’s note: To read the final rule, click here. To read additional coverage from the American Hospital Association, click here.