Home Health Integrity and Protection Bill

by Kristin Rowan | Oct 16, 2026 | Advocacy, CMS, Medicare, Regulatory

by Kristin Rowan, Editor

Medicare Home Health Fraud Protection Bill

Companion bills in Senate and House

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.

HHA Screening

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

Scrutiny of unusual circumstances

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.

Surveyor requirements

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.

Fraud prevention and enforcement resources

The bill proposes $550 million in additional resources allocated to:

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

Reimbursement rate changes

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.

Bill endorsed by national associations

“We are grateful to Representative Tenney for leading this important effort in the House. Medicare home health payment should be built on reliable data, not on numbers distorted by fraud. This legislation fixes the flawed math behind years of compounding cuts and gives CMS the tools to stop bad actors before they receive federal funds. With bills now in both chambers, Congress has a clear path to protecting access to essential home health services.”

Jennifer Sheets

CEO, National Alliance for Care at Home

“This bill’s oversight provisions are reasonable, appropriately targeted policies that would help maintain the benefit’s integrity. Those, along with the important proposed payment changes, will help to ensure support for legitimate providers—including our nonprofit and mission-driven members. We look forward to working with Senator Collins to advance this legislation.”

Katie Smith Sloan

President and CEO, LeadingAge

Where the bills stand

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.

# # #

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

HCAOA Announces Medicaid Advocacy

by Kristin Rowan | Oct 16, 2026 | Advocacy, Medicaid, Partner News, Regulatory

by Kristin Rowan, Editor

HCAOA Expands Medicaid Advocacy

Medicaid Expert Announced

The HCAOA Annual Meeting was a-buzz with rumors of a new staff member joining the team. The announcement was scheduled during the opening session with Jason Lee, but was postponed. Lee mentioned it almost as an aside in his opening address. He said, “we’ll have a new medicaid and government relations and expert on our staff. So looking forward to an exciting announcement next week.”

News Spread

Attendees noticed Lee’s statement and began speculating about who the new expert on staff would be and why Lee didn’t name them in his opening address.

An inside source told The Rowan Report that the announcement had been delayed at the insistance of the new employee’s then current employer.

By the end of the first day of the annual event, many attendees were speculating about the announcement. Some correctly guessed the identity of the new employee while others were off the mark. Either way, the delay of the announcement created anticipation better than any marketing campaign.

At Long Last

On Oct 6, more than a week after the announcement was initially scheduled, new HCAOA Senior Director of Communications, Marketing, and Education Allison Dolan sent the press release announcing the organization’s expanded Medicaid advocacy focus. The announcement named policy expert Damon Terzaghi as Vice President of Public Policy.

You can read the full HCAOA statement here.

Expertise

The press release reads, “Terzaghi brings more than two decades of experience in Medicaid, long-term services and supports (LTSS), aging, disability and home-based care policy across federal and state government, national associations and the private sector. He most recently served as vice president of Medicaid and home care policy at the National Alliance for Care at Home, and has held roles at the Centers for Medicare & Medicaid Services, Advancing States, the Marwood Group, the National Association of State Medicaid Directors and the Oregon Department of Human Services.”

In his Own Words

“We are at a crucial inflection point in long-term services and supports in our country, as demand far exceeds capacity and more participants turn to Medicaid programs to finance their care. With the enrollment and spending growth in these programs, beneficiaries and providers are facing more and more difficult questions, ranging across access, workforce, payments, quality, and program integrity. I’m eager to hear directly from HCAOA members and make sure our policy discussions reflect their experiences.”

Damon Terzaghi

Vice President of Public Policy, Home Care Association of America

Medicaid Goals

HCAOA CEO Jason Lee said, “Medicaid is core to how many of our members do business, creating a growing need for expertise and advocacy….”

The new Medicaid advocacy focus will connect federal policy developments with state-level implementations, according to the press release. The association will work on reimbursement, workforce capacity, regulatory requirements and access to care. The plan includes creating Medicaid resources for its members.

# # #

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

HCAOA: Past, Present, Future

by Kristin Rowan | Oct 16, 2026 | Advocacy, Home Care, Medicaid, Regulatory

by Kristin Rowan, Editor

HCAOA: Past, Present, Future

An Interview with Jason Lee and Aaron Stapleton

During this year’s HCAOA annual meeting, The Rowan Report sat down with association CEO Jason Lee and outgoing board president Aaron Stapleton. We talked about the accomplishments during Stapleton’s tenure, this year’s annual meeting, and what’s in store for HCAOA in the coming years.

Stapleton set priorities for his term

As HCAOA board president, Aaron Stapleton set three priorities: raise the association’s visibility, strengthen membership and build strategic partnerships. Stapleton said the work is beginning to change how policymakers and the broader health care community understand home care.

CEO Jason Lee Board President Aaron Stapleton HCAOA

Visibility

Stapleton said greater recognition matters because home care remains less understood outside its own professional community. Advocates, patients, families and lawmakers need a clearer picture of what home care providers do and how their services fit into the wider health care system.

“We’re actually having conversations, not introducing who we are and what we do, but building off of previous years. I went into a legislator’s office this year and she said she remembered our conversation from last year. To me, that said these people are getting it; they’re understanding what we do.”

Aaron Stapleton

Board President, Home Care Association of America

Lee's focus on growth

Membership growth is another measure of progress. Lee said HCAOA had grown to more than 5,300 members, up from about 4,600 the previous year. He credited the association’s staff and board, as well as the value members find in advocacy, education and professional connections.

Partnership efforts

Lee and Stapleton pointed to partnerships as another way to amplify the sector’s voice. HCAOA has been building relationships with organizations including the Alzheimer’s Association and other national and state-level groups. Stapleton said the goal is not simply to announce partnerships before his term ends, but to open doors that can develop into lasting relationships.

“The more you co-brand things, the stronger the voice is,” Stapleton said.

Advocating for the caregiver profession

Another priority for both leaders is changing how the work is described. They objected to the term “unskilled” when applied to home care, saying it diminishes the training, judgment and oversight involved in supporting older adults and other people who need assistance. Stapleton said he would like the industry to use “care professional” more consistently to distinguish trained, employed caregivers from the broader category of family caregiving.

That distinction is about more than terminology, they said. Home care workers can help identify safety risks, support medication routines and reduce the likelihood that vulnerable people will need hospital care. Stapleton described home care as a proactive part of the health care continuum—one that can help people remain safely at home while easing pressure on families and the wider system.

The leaders acknowledged that training and licensing requirements vary by state. Lee said HCAOA has model legislation and regulations that can help states develop home care licensure frameworks, and that the association is considering a gradual approach to credentials and broader accreditation. The aim, he said, is to establish a meaningful baseline without creating unnecessary burdens for agencies that are already operating responsibly.

2027 and beyond

As Stapleton’s term approaches its end, he said his focus is on finishing strong: continuing to support Lee and the association, sustaining membership and partnership growth, and preparing incoming president Sarah Wilson for a smooth transition. He said the next leader should be able to build on existing work while bringing her own strengths and perspective.

For both leaders, the larger goal is to make home care more visible and better understood—not only by policymakers, but by health care partners and the public. They see stronger membership, broader partnerships and more personal stories from families and caregivers as ways to make that case.

Final Thoughts

I want to thank Jason and Aaron for sitting down with me during this year’s annual meeting for HCAOA. I also want to thank HCAOA for their continued support of The Rowan Report. The annual meeting is always educational and I enjoy reconnecting with members, vendors, and staff. Until next year.

# # #

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

HCAOA Annual Event Preview

by Kristin Rowan | Sep 25, 2026 | Advocacy, Events, Home Care, Partner News, Regulatory

by Kristin Rowan, Editor

HCAOA Annual Event Preview

Woah!

Orlando, Florida is known for its warm weather and sunny days. But, next week, Orlando will be “cool!” The opening keynote speaker at the HCAOA National Home Care Conference is Mr. Cool himself, Arthur Fonzarelli. Henry Winkler, aka “The Fonz”, is an Emmy Award-winning actor, director, producer, and best-selling author. He is also an advocate for people who learn differently. This year’s keynote address will certainly kick things off with humor and inspiration, but “Ayyy” that’s just the beginning.

Headliners

Joining Winkler in this year’s lineup are Disney executive Louie Gravance talking about service excellence and comedian turned motivational speaker Jeff Civillico. Gravance is the featured speaker for the opening session on day 2 of the event. Civillico is the emcee on the main stage throughout the conference.

Education

If you’re heading to HCAOA next week, expect a busy schedule. The hardest part will be deciding which sessions to attend when some of the best minds in the industry have overlapping time slots.

Home Care CEOs and software solutions providers will present real-world applications and use cases for AI in home care, workforce solutions for developing caregivers and preparing for the future, operations guidance on benchmarking, cultivating cultural connections, recruitment, employment law, and finance and marketing.

For Floridians, HCAOA has a state-focused session track including regulatory and compliance updates a Florida Advocacy Forum.

Fun & Games

Some of the best networking opportunities are often accompanied by a glass of wine, a coffee, or an award. Don’t miss the vendor networking breakfast and lunch, the networking reception on Monday night, and the presentation of the Caregiver of the Year Award on Tuesday morning. And, of course, if you stick around after the reception on Monday, you’re bound to find most of us at the hotel bar.

Worth the Trip

The Home Care Association of America hosts a stellar event every year and this year is shaping up to be no different. I look forward to seeing many of you in Orlando next week. Plan your schedule here.

# # #

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

Viventium | Apploi: CEO Interview

by Kristin Rowan | Sep 25, 2026 | Admin, Partner News, Recruitment & Retention, Vendor Watch

by Kristin Rowan, Editor

Viventium CEO Interview: Adam Lewis

From time to time, The Rowan Report invites our partners to participate in a video interview. Earlier this year, we sat down with Viventium CEO Navin Gupta. Last week, we had the pleasure of speaking with Adam Lewis, Founder of Apploi and General Manager of Talent and Workforce Management at Viventium.

Adam brings years of experience and passion for care at home to Viventium after its acquisition of Apploi earlier in 2026. The Viventium and Apploi merger creates a seamless, end-to-end management platform from recruitment to the first paycheck.

# # #

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

MatrixCare Leaves Resmed

by Kristin Rowan | Sep 4, 2026 | M&A, Vendor Watch

by Kristin Rowan, Editor

MatrixCare is Independent Again

Resmed Acquisitions

In 2019, Resmed (formerly ResMed) acquired MatrixCare for $750 million. Resmed also acquired Healthcare First (2018) and Citus Health (2021) and bundled them under the MatrixCare brand. Resmed also acquired Brightree in 2016 and several other software companies that are outside the care at home ecosystem.

PE Firm Acquires MatrixCare; Names CEO

On September 1, 2026, private equity firm Frazier Healthcare announced its acquisition of MatrixCare. According to records, the sale included both Healthcare First and Citus Health. Brightree was not included.

Frazier named Jonathan Lujan as CEO of MatrixCare. Lujan, a Frazier Executive in Residence, most recently served as CEO of Sight Growth Partners, an administrative services provider in the vision care field. The press release from Frazier notes that Lujan has experience in healthcare and technology.

“Frazier has spent several years evaluating the post-acute care technology sector and believes MatrixCare has established itself as a leading platform serving skilled nursing, senior living, and home health and hospice providers. We are excited to partner with the MatrixCare team and to invest in the product innovation and capabilities customers need as the post-acute care landscape continues to evolve.”

Ryan Lucero

General Partner, Frazier Healthcare Partners

MatrixCare Announces Independence

In a separate press release on Tuesday, MatrixCare announced its independence from Resmed. The press release also included the appointment of Lujan as CEO, but did not mention Frazier Healthcare. Lujan’s experience and job history was identical in both announcements.

Lujan Statement from Frazier

In the Frazier press release, Jonathan Lujan says:

“MatrixCare has built a trusted platform with a strong market position and a critical role in the daily operations of post-acute care providers. I am excited to work alongside the MatrixCare team and Frazier to build on that foundation, accelerate product innovation, and help our customers deliver better outcomes for the people and providers they serve.”

The MatrixCare press release also included a quote from Lujan:

“Today marks an important milestone for MatrixCare. As an independent company, we have the focus and the resources to invest directly in our platform and our people. We will build on more than 40 years of trust earned with skilled nursing, senior living, home health, and hospice providers, and we will move faster to deliver the innovation our customers need. This is the start of MatrixCare’s next chapter, and I’m excited to lead the team into it.”

Final Thoughts

It is unclear at this time why the MatrixCare announcement did not mention Frazier Healthcare. The company left the Healthcare First and Citus Health platforms out of the press release as well. Whether Lujan works for Frazier or MatrixCare is also ambiguous. The Rowan Report reached out to MatrixCare for comment and has requested an interview with Lujan.

# # #

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

HHAeXchange Launches RCM Services

by Kristin Rowan | Sep 4, 2026 | Admin, Home Care, Medicaid, Partner News, Vendor Watch

by Kristin Rowan, Editor

HHAeXchange Announces RCM Services

An Interview with Phil Feldman

In April of 2026, HHAeXchange unveiled their new end-to-end Revenue Cycle Management (RCM) service. HHAeXchange is a leading provider of homecare program management designed for Medicaid Home and Community-Based Services. (HCBS).

Addressing Top Concerns

HHAeXchange’s 2025 Provider Voice Survey asks homecare agencies about the pain points facing the industry. Administrative workload and cost are significant areas of concern for homecare agencies, cited by 41% of providers. RCM services address these concerns by removing administrative tasks from agencies, freeing up personnel to focus on growth, community outreach, referrals, and caregiver training.

“Homecare providers are navigating diverse payers, rising costs, growing administrative demands, and an increasingly complex financial and regulatory environment. RCM Services relieves agencies of the operational burden of billing and collections while improving cash flow and business performance. By offloading revenue cycle management to experts who deeply understand homecare and the HHAeXchange platform, agencies gain clarity, efficiency, and more time to focus on care.”

Paul Joiner

CEO, HHAeXchange

From Submission to Resolution

End-to-end RCM services handle the full revenue cycle. The RCM Services team at HHAeXchange handles everything from the initial claim submission to handling discrepancies, resolving rejections, appealing denials, and shortening the cycle of aging receivables.

Improved Cash Flow

RCM services go beyond billing and collections. HHAeXchange uses operational intelligence to track denial trends, authorization issues, and payer challenges. With these issues addressed at the beginning, claims are cleaner, denials are reduced, and agencies stay in compliance. These are issues cited by 70% of homecare agencies.

With improved cashflow, agencies have the resources to grow, to invest in their staff, to scale operations, and to create a more stable work environment.

Phil Feldman, National Director of RCM

The Rowan Report sat down with Phil Feldman, the National Director of RCM for HHAeXchange. Feldman, and the RCM service platform, came from Sandata and joined HHAeXchange in the acquisition in 2024. We asked Feldman about RCM services:

The Rowan Report:

What makes HHAeXchange’s RCM different?

Phil Feldman:

The RCM service platform is specific. It is specific to home care, specific to Medicaid, and specific to HHAeXchange. Agencies are connected to resources within the organization. We have existing relationships with payors that we can resolve directly. And the customer-facing team, the experts handling your revenue cycle, are employees of HHAeXchange, not a partner or a 3rd party.

RR:

What is the agency experience with HHAeXchange’s RCM service?

Feldman:

We are currently only offering the RCM services within the HHAeXchange platform. You have one vendor and one platform. When there’s a finger to point, it points right back at us.

Every account has at least one RCM advisor who serves as the primary point of contact, working with the agency on their billing schedule, their time-keeping week, and the whole process from close to claim.

The intelligence in the platform goes beyond mechanically processing claims and takes a holistic approach. The system checks for demographic descrepancies from intake like member IDs, gender alignment, ID updates from new payors, overservicing on claims, providing services past the end date or outside allotted days. We look directly at the agency’s denial trends and go upstream in the revenue cycle to fix the whole process, not just one claim.

Results

With just under five months since the full launch, and nearly a year of data from beta test agencies, Feldman says their agency claims are in the 90% collection rate. Claim denials, clawbacks, and remit time are trending down. A full data set is forthcoming, but for now, Feldman is relying on anectodal evidence: Their customers are referring agencies that are looking for RCM solutions.

“You’re the best thing ever. I have a lot of friends that I consult with and help them run their business. I want to introduce them to you.”

– An Indiana Agency Owner

Final Thoughts

Hiring and retention issues, reimbursement rates, administrative workload, operational costs, denials, payor compliance, authorizations…these issues are universal across home care and aren’t going away any time soon. If you’re looking for ways to optimize your current workforce, reduce overhead costs and tasks, and create a steady cash flow for your agency, outsourcing RCM is one way to do it. If you’re already an HHAeXchange customer, well, it just makes good sense to work within the system you know, with advisors who take time to understand your agency, and the backing of decades of experience.

# # #

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

VA Policy Causes Death of Veteran

by Kristin Rowan | Aug 14, 2026 | Advocacy, Regulatory, Veterans Affairs

by Kristin Rowan, Editor

VA Policy Causes Death of Veteran

For the last couple of months, we’ve been reporting on the rate and hours changes from the VA in Texas and NM. Caregivers are taking pay cuts. Agencies are operating at a loss in order to continue serving our veterans. Many veterans are losing their caregiver, losing the comfort of having a familiar person in their home, losing the progress they’ve made against depression, PTSD, and isolation. And now, we’ve heard a story that we just cannot believe.

Last week, I spoke with an agency owner operating across four states. The agency has been impacted by the rate cuts in Texas and New Mexico. His story is disturbing and highlights the darkest realities of this policy. Here is his story:

End of Care

The administration in one VA not only cut the rates and cut veteran hours, but also just ended care for some veterans and kicked them out of the program. There were no in-home visits or assessments. A member of the VA office made phone calls and asked veterans if they needed care. One of these phone calls reached a veteran with dementia. She didn’t remember the 16 to 20 hours of ADL care she was receiving to dress, eat, and bathe every day. She told the caller she did not need care and the VA dropped her from the program completely.

End of Life

Another veteran, another call to determine whether he needed care, and another drastic cut in hours. This veteran needed home visits daily. He needed supervision and check-ins. The VA didn’t see it that way and cut his care down to six hours per week. The agency shifted from regular visits to twice a week. The caregiver saw him on Friday. He fell on Friday after the visit or sometime on Saturday. He lay in his home, alone and afraid, all weekend long. He died sometime Monday. The caregiver found him when she returned to the home on Tuesday.

End of a Deadly Policy

The rate cut at the federal level, the care balance between Home Health Aide and Homemaker, the cut in hours, the end of care without an assessment, and the unwillingness of the policymakers to acknowledge the lives they have put at risk has to end. If Texas and New Mexico serve as test runs for policy change and rate cuts across the country, all our veterans could suffer like the ones in this story, and countless others. Your agency could be next. If you haven’t already, please join the fight for veteran care.

Write a letter to Secretary Collins admonishing him for the rate cut and for believing it wouldn’t impact care.
Mail to: Office of the Secretary, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420
Send a general inquiry to Ask VA
Join the coalition with Polsinelli – PolsinelliHomeCare@polsinelli.com

Final Thoughts

These stories are not the only ones out there. Veterans across Texas and New Mexico are suffering from the loss of care. Agencies dedicated to that care are shuttering their doors from upside down reimbursements. My source said it better than I ever could.

“My hope is that by sharing some of the difficult situations we’ve encountered, the article will help shed light on the real-world consequences of these decisions. I hope it encourages meaningful discussion about how we can better support our senior veterans. I truly believe there are better ways to reduce costs than by limiting access to the care they depend on. These men and women have already sacrificed so much in service to our country. As they age, caring for them should be one of our highest priorities, and we should treat each of them with the respect and gratitude they have earned.”

# # #

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

2027 Home Health Proposed Rule

by Kristin Rowan | Aug 7, 2026 | CMS, Home Health, Regulatory

by Kristin Rowan, Editor

2027 Home Health Proposed Rule

The Alliance Responds

On July 1, 2026, CMS released the 2027 Home Health Prospective Payment System proposed rule. The proposed rule includes updates to base pay, quality reporting system, value-based purchasing model, medicare provider enrollment, and DME policies. CMS is also considering ways to include palliative care. The comment period ends August 31, 2026.

The National Alliance for Care at Home issued a press release following the proposed rule publication.

“While the proposed rate update results in increased payments relative to last year – a reflection of our continued advocacy and a much-needed reprieve for providers under the stress of increasing costs – the Alliance remains focused on working to stop unwarranted temporary adjustments that are based on a flawed methodology with underlying data integrity issues. We will continue to partner with CMS on policies that strengthen the Medicare home health benefit. Ultimately, federal policy must preserve patient access to care at home, which remains the preferred choice of care for millions of families.”

Jennifer Sheets

CEO, the Alliance

Permanent and Temporary Rate Adjustments

CMS uses data from 2020 through 2025, actual and expected behavior changes resulting from the implementation of PDGM, and calculated overpayments from prior years to determine rate adjustments.

The actual CY 2025 base rate was $2,057.35 and the recalculated rate is $1,953.60; a difference of 5.043%
Prior permanent adjustments of -1.975% in 2025 and -1.023% in 2026 are factored in, but not directly subtracted
The 2024 budget-neutral rate multiplied by case-mix weights, wage index, and payment update factors yield the 2025 budget-neutral rate of $2,036.29, a difference of 1.024%
Estimated retroactive overpayments from CY 2020 through CY 2025 of $4,9 billion to be partially collected with a -3.0% temporary adjustment to the base pay rate.
Recalibrating the case-mix weight using reporting from CY 2025, CMS calculates a budget neutrality factor for CY 2027 of +1.0045
Applying the market basket (wages across the U.S.), CMS proposes a 3.0% increase to the home health market basket, offset by a -1.0% productivity adjustment, yielding a 2.1% increase.

With these calculations, CMS proposes a -3.0% temporary adjustment to be applied for CY 2027.

The Alliance acknowledges and appreciates the headway made with CMS in understanding the true cost of delivering home health care and the value it provides to the millions of Americans who depend on it. However, the Alliance emphasizes that Medicare payment rates – with the 3% temporary adjustment applied – still do not align with the actual cost of providing comprehensive, high-quality care. In a recent letter to CMS, the Alliance encouraged CMS to eliminate all permanent and temporary adjustments due to problems in the data and analyses used to calculate payment rates.

Alignment of HH QRP and HHVBP

CMS is considering changes that would better align measure sets, reporting perioeds and assessment process between HH QRP and HHVBP. The considered changes are:

Increasing alignment in expanded HHVBP Model and HH QRP Quality of Patient Care (QoPC) Star Ratings measure sets.

Aligning HH QRP and expanded HHVBP Model measure reporting periods.

Modifying HH QRP APU and expanded HHVBP Model annual payment reporting periods.

Altering expanded HHVBP Model Interim Performance and HH QRP QoPC Star Rating Reports.

Aligning timeframe of appeals/suppression review processes for the expanded HHVBP Model and HH QRP.

Updating scoring methodology to incorporate HH QRP APU penalties in expanded HHVBP Model payment adjustments and factoring HH QRP Quality Assessments Only (QAO) values into QoPC Star Ratings scoring.

CMS is NOT asking for comments at this time. The Technical Expert Panel meeting in 2025 discussed this alignment.

Read the TEP Summary Report.

LUPA Updates

CMS proposes updates to the functional points table and the table of functional impairment levels by clinical group. The proposed updates are:

Requests for Comment

Send your comments to CMS by August 31, 2026

CMS is soliciting comments on the proposal of applying a -3.0% temporary rate adjustment instead of applying a permanent adjustment.

There are proposed changes to the criteria for selecting and prioritizing HH QRP measures, identifying measurement gaps, and measures for filling those gaps. CMS is requesting input on the measure concepts as the relate to advanced care planning.

For CY 2027, CMS is using the hospital wage index as the basis for its calculations for the home health wage index. While they believe this is the best method, they are looking for information on alternative data sources such as occupation-level wage data or other publicly available wage data. They are exploring whether such data might better reflect geographic variations in labor costs for HHAs. CMS is concurrently exploring additional wage data for hospices, SNFs, and inpatient rehab facilities.

CMS is inviting public comments on the CY 2027 proposed case-mix weights and case-mix weights budget neutrality factor.

# # #

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

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