WNU Week of August 18, 2025
Model Comment on Proposed 2026 Home Health Prospective Payment System (HHPPS)
CAHSAH has developed a Model Comment on the Centers for Medicare & Medicaid Services’ (CMS) home health (HH) prospective payment system (PPS) proposed rule for calendar year (CY) 2026.
CAHSAH encourages all providers to submit comments before the comment period ends on August 28, 2025. Please review CAHSAH's Call to Action for instructions on how to submit comments. Download Model Comment Letter
DOL Proposal: Reinstate Companionship & Live-In Exemptions
On July 25, 2025, the U.S. Department of Labor issued Field Assistance Bulletin 2025-4 instructing field offices and investigators to stop enforcement of the 2013 final rule immediately. This means investigators must not start or continue any investigation or otherwise take any other enforcement action against a third-party home care agency employer that claims the companionship or live-in exemptions. The proposed regulations are still in a public comment period. Requests to extend the comment period have been submitted, but as of the date of this update the deadline for comments is September 2, 2025. Read More
Hospice 2026 Final Payment Rule Released
The Centers for Medicare and Medicaid Services (CMS) has issued the fiscal year (FY) 2026 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program final rule. The overall impact of the rule is an estimated $750 million increase in hospice payments relative to FY 2025. While CMS sees this as a payment increase, the hospice industry is very concerned about the inadequacy of this increase given the current economic conditions our nation faces with the rising cost of gas, medical supplies, and wages.
Key provisions of the rule include:
- Final Payment Rate Update. CMS is finalizing a 2.6% update for FY 2026, which reflects a 3.3% market basket percentage increase, decreased by a 0.7 percentage point productivity adjustment. Comparatively, CMS proposed a 2.4% update for FY 2026.
- Final Hospice Cap Amount. CMS finalizes a hospice cap amount for the FY 2026 cap year of $35,361.44, which is equal to the FY 2025 cap amount ($34,465.34) updated by the final FY 2026 hospice payment update percentage of 2.6%.
- Hospice Admission Recommendations. CMS finalizes its proposal to update 42 C.F.R. § 418.25 to add the “physician member of the hospice interdisciplinary group” as a physician who can make a recommendation for admission to hospice.
- Face-to-Face Encounter Attestation Requirements. Rather than finalize its proposal to revise face-to-face attestation requirements at 418.22(b)(4) to explicitly require the signature and date of signature on the face-to-face encounter, CMS adopts the Alliance's recommendation to allow a signed clinical note to serve as the attestation that a hospice physician or nurse practitioner completed the face-to-face encounter and the date completed.
- Hospice Outcomes and Patient Evaluation (HOPE) Implementation. Despite pushback from the national hospice trade community, CMS is moving forward with its decision to implement the HOPE tool with data collection beginning October 1, 2025 .