Federal Home Health and Hospice Updates
(Sept. 9, 2025) Please find below home health and hospice updates from LeadingAge National:
Legislation Introduced in House to Delay Devastating Home Health Cuts. On Sept. 4, 2025, U.S. Representatives Kevin Hern (R-OK) and Terri Sewell (D-AL) introduced the bipartisan Medicare Beneficiary Home Health Access Protection Act of 2025, which would require the Secretary of Health and Human Services to issue a special rule for Calendar Year (CY) 2026 and CY 2027 to provide a positive adjustment to the standard payment and fully offset the -4.059% permanent adjustment and -5% temporary proposed for CY 2026 and any future behavioral adjustments for CY 2027.
Katie Smith Sloan, president and CEO of LeadingAge National, said of the legislation:
"Home health agencies deliver critical services that help older adults in healthcare recovery or ongoing aging in place. The deep cuts in Medicare fee for service payment currently proposed threaten beneficiaries’ access to care and all providers’ viability–and may have a disproportionate impact on our nonprofit and mission-driven provider members by eroding their ability to serve as safety net partners, to accept complex referrals, and to maintain essential community services like vaccination programs. We appreciate that Representatives Hern and Sewell recognize both providers’ need for relief from these looming reductions and the importance of older adults’ and families’ ability to continue to access care. This legislation relieves payment pressure, short-term, and ensures the time needed to work toward a sustainable solution. We wholeheartedly support it and appreciate the leadership of Representative Hern and Representative Sewell on this critical issue.”
When the bill number and text become available, LeadingAge NY will share with members.
In comments submitted to the Centers for Medicare and Medicaid Services (CMS) responding to the CY 2026 Home Health Proposed Payment Rule, LeadingAge National expressed grave concerns over the impact of the deep reductions in Medicare fee-for-service (FFS) payment rates the agency put forth in its rule, including reduced access to home health care. LeadingAge National's press statement can be found here. LeadingAge NY's comments on the proposed rule are here.
Hospice Medical Signature Requirements. On Sept. 4, 2025, CMS released revised guidance for Medicare signature requirements. As part of the Fiscal Year (FY) 2026 Hospice Final Rule, CMS finalized proposals to require attestation of the face-to-face encounter for hospice, adding to the original proposal that a signed and dated clinical note from the physician or nurse practitioner conducting the face-to-face would suffice to meet the requirement.
Now, with the Sept. 4th guidance, CMS has updated guidance for complying with Medicare signature requirements to expand on the rights of professionals with disabilities to use stamp-based signatures, including a note on the use of Artificial Intelligence (AI) scribes, and detailed instructions on the timeline contractor review.
The revised information states that a Medicare Administrative Contractor (MAC) or other contractor may request a signature attestation or log from the billing entity to fulfill a requirement or for authenticity purposes. From the point of either phone contact or receiving a request letter, providers will have 20 calendar days to submit the documentation. In cases where these attestations or logs are requested, the review period is extended by 15 calendar days. If a signature attestation or log resolves the signature issue, the contractor will consider the contents of the medical record entry.
LeadingAge National, Hospice Associations Ask Congress to Extend Hospice Face-to-Face. On Sept. 5th, LeadingAge National, the National Alliance for Care at Home, and the National Partnership for Healthcare and Hospice Innovation sent a letter to congressional leadership urging Congress to extend the telehealth flexibilities for the face-to-face encounter required for recertification of hospice eligibility. Without an extension from Congress, this COVID public health emergency waiver will end Sept. 30, 2025.
Contact: Meg Everett, meverett@leadingageny.org