TMWhat the New Home Health Payment Integrity Bill Means for Agencies
This week the House got its own version of a bill that home health advocates have been pushing for months. On Oct. 13, Rep. Claudia Tenney (R-NY) introduced the Medicare Home Health Payment Integrity and Protection Act of 2026, a companion to Senate bill S. 5250 that Sens. Susan Collins (R-ME) and Marsha Blackburn (R-TN) filed in August. The home health payment integrity bill would do two things at once: give CMS sharper tools against fraudulent agencies, and reset 2027 Medicare home health payment rates using data that strips out fraudulent billing and accounts for how care changed after COVID.
What the home health payment integrity bill would change
According to the bill text and McKnight's Home Care reporting, the package would verify administrator identities before enrollment, require more frequent surveys of new and ownership-changed agencies, raise penalties for failing to submit quality data, and hold accrediting organizations to CMS-level standards. It would also fund accelerated surveys, site visits, and enforcement work at CMS, DOJ, and state survey agencies. The payment side is just as important to agencies that play by the rules: CMS would recalculate prospective payment amounts with reliable data, so bad actors in a few markets stop pulling down rates for everyone else. The National Alliance for Care at Home called that "fixing the flawed math behind years of compounding cuts."
Why agencies are watching both chambers
Fraud crackdowns and payment cuts have been colliding all year. CMS's nationwide enrollment moratorium on new home health and hospice providers, set to expire Nov. 13 unless extended, has slowed growth even for compliant agencies. LeadingAge, the Alliance, and other groups have told CMS they want a "scalpel and not a shotgun": risk-based reviews, better site visits, and less collateral damage for agencies with clean survey and quality records. Collins' office notes that traditional Medicare home health beneficiaries fell from about 3.3 million in 2019 to 2.7 million in 2024, while anomalous concentration of agencies and spending in places like Los Angeles County has distorted the national rate-setting data. A House companion now means both chambers have a live vehicle for that targeted approach.
None of this is law yet. H.R. 10806 was referred to Ways and Means, Energy and Commerce, and Judiciary. Still, the direction of travel is clear for ops leaders: keep quality reporting current, keep ownership and administrator records tidy, and make sure visit and documentation trails can stand up to closer review. Tools that show planned versus completed visits in one place, the way CareSync® does, make it easier to answer those questions without digging through spreadsheets when a surveyor or auditor asks.
Sources: McKnight's Home Care on the House bill, Senator Collins press release, McKnight's on targeted fraud enforcement, LegiScan H.R. 10806.