Capitol Corner | October 2025

Last month, I spent quite a bit of time reading CMS’2026 Home Health Prospective Payment System proposed rule.  It ran for ____pages in the Federal Register.  I also read the National Alliance for Care at Home (the Alliance) comment.  The Alliance’s comment was itself 62 pages long.  Kudos to the Alliance for they did a very nice job in identifying the shortcomings of the proposed rule.  Finally, I talked to CAHSAH members about their thoughts on the Medicare PPS.  What they had to say got my attention.  They said the challenge of OASIS and HHCAHPS was daunting.  They told me that the PDGM system was 40 percent unrealistic.  They explained that a system that paid $103 for a month for wound care supplies was ludicrous.  They told me that the proposed system would certainly decrease access for Medicare patients and that rehospitalizations would certainly result. 

I became convinced that CAHSAH needed to educate our members on the complexity of this system and the impact of the 2026 changes.  After all, their Medicare payments depended on it.  Later this month, CAHSAH will produce workshops in Northern and Southern California on the PDGM Model and the 2026 changes.  We recruited one of the nation’s experts to be our faculty, Melinda Gaboury. 

I hope CAHSAH’s members will take advantage of this opportunity to educate themselves on the intricacies of the Medicare prospective payment system.  Their agency’s health may rest in the balance.