by Kristin Rowan, Editor

In August of this year, Senator Collins (R-ME) introduced the Medicare Home Health Payment Integrity and Protection Act of 2026 (S.5250). The bill would amend title XVIII of the Social Security Act. Its proposed actions would add tougher fraud prevention, more oversight, more enforcement resources, and an adjustment to Medicare payments for 2027.

On October 13, Congresswoman Tenney (R-NY) introduced a companion bill in the House.

For agencies identified as extreme fraud risk, the bill proposes:

• Enhanced screening, including fingerprinting agency administrators
• Proof of comprehensive liability insurance
• Additional scrutiny under some circumstances, namely a marked local increase in HHAs

HHAs whose actions point to potential fraud or compliance issues would see increased oversight. New agencies would see more frequent surveys. Agencies with new ownership likewise would see increased verification and inspection. The bill also proposes additional scrutiny and oversight of agencies that miss quality data reporting requirement or have unusual admission patterns.

Accreditation bodies would have new surveyor requirements under the new law. Specifically, the survey procedures must meet or exceed state and local agency standards as agreed to with the Secretary of Health and Human Services. Surveyors must also complete CMS training courses and stay in compliance with a performance assessment that the Secretary must establish. The assessment would include remedies for accreditation bodies not in compliance including corrective plans, ongoing monitoring, and/or termination of approval.

• CMS program-integrity activities
• Department of Justice and HHS Inspector General fraud enforcement
• Inspections, enrollment validation, and operational verification by state survey agencies

The bill changes the standard payment amount and some adjustments under the PDGM. The standard prospective payment for 2027 would be $2,382.87. This is a substantial increase over the 2027 proposed base payment rate of $2,092.27.

The bill also removes all permanent and temporary adjustments for 2020 and all subsequent years. It states that the Secretary will not “impose any adjustment to offset increases or decreases in extimated expenditures attributable to the difference in assumed versus actual behavioral changes due to the implementation of the PDGM….”

Finally, the bill proposes that suspect claims and claims from fraudulent providers will not be used in calculations for payment benchmarks and value-based adjustments.

Collins’s Senate bill was read twice referred to the Senate Committee on Finance on August 5, 2026. The House bill was introduced this week and has not yet been referred to a Committee.

The Rowan Report will provide updates as these bills move through the House and Senate. We don’t expect any additional action prior to the upcoming election cycle. 

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Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites.  Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com