Capitol Corner | August 2025
For this mid-summer edition of Capitol Corner, we travel 3,000 miles and three time zones from Sacramento to Washington, D.C. And with the State Assembly and State Senate in the midst of their annual one-month Summer Break, we focus today on the federal Department of Health & Human Services led by Secretary Robert F. Kennedy Jr., and its Centers for Medicare & Medicaid Services (CMS) headed by Dr. Mehmet Oz.
While these names are very familiar, and with the unique coincidence of both entities being helmed by a political (Kennedy) and an entertainment (Oz) celebrity, what has most recently come out of CMS threatens the existence of the home health our industry.
As background, each year CMS releases a Proposed Home Health Rule followed by a Final Home Health Rule for the next year. And the same applies to Hospice with an annual Proposed and Final Rule. These Rules cover innumerable provisions and regulations governing how these programs operate, but arguably the most impactful aspect of the Rules is the annual recalculation of reimbursement rates for Medicare program certified providers responsible for providing Home Health and Hospice services to Medicare beneficiaries.
Every year, CAHSAH comes together with our state association colleagues across the nation and works in extremely close collaboration with our national leader, the Alliance for Care at Home (“The Alliance”), to review and analyze these Rules and make recommendations on how they can be improved with a recurring argument that the methodology CMS annually employs to calculate Home Health and Hospice reimbursement rates is beyond flawed.
Just a few weeks ago, CMS released its 2026 Proposed Home Health Rule that shockingly calls for a 9 percent reduction in the 30-day episode reimbursement rate – the largest single year rate cut in recent CMS history. That rate cut includes a roughly 4% permanent cut and a 5% temporary cut. In response to this absurd reimbursement rate reduction, we are working with the Alliance to challenge this ridiculous policy and convince them that the 12% collective reduction in Home Health reimbursement rates since 2023 not only puts the vast majority of agencies at financial risk, but truly threatens the ability of our industry to provide the home health services our patients need and deserve.
We offer this vignette to illustrate the work we do on the federal level to protect our members and fight for them when they are being unfairly targeted. We obviously bring the fight daily to the California Legislature, our state government’s health care bureaucracy, and the Congress of the United States. But rest assured that we also fight this and other battles on a regular basis to HHS and CMS where so many of the rules, regulations, and reimbursement decisions impacting our very existence are formulated and implemented.