Federal Update

In today's federal update we will cover MedPAC’s recommendation that Congress cut home health and freeze hospice rates, and comments from our national association on proposed Medicare Advantage plan changes.

MedPAC Vote on Medicare Payments

In January, the Medicare Payment Advisory Commission (MedPAC) convened to finalize its recommendations on Medicare payments, including for home health and hospice, and on March 13 they published the March 2025 Report to Congress: Medicare Payment Policy.

It is important to remember that MedPAC’s role is advisory, and that recommendations made by MedPAC would need to be acted on by Congress to go into effect. MedPAC has a long history of recommending cuts to home health and hospice.

For Calendar Year 2026, MedPAC is recommending that Congress cut the 2025 Medicare base payment rates for home health care services by 7% and freeze hospice payment rates.

Alliance Comments on Proposed Medicare Advantage Plan Changes

The Alliance for Care at Home has submitted comments on the proposed Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Programs.

Migration to Medicare Advantage plans, which often pay at very low rates, is a significant challenge facing Vermont’s local, designated home health and hospice agencies.

While the proposed rule is not specific to home health, there are provisions that could be impactful to the organizations, like VNAs of Vermont member agencies, who provide care in the home.

Alliance comments included a recommendation that that CMS clarify the circumstances with which the Medicare Advantage plan is prohibited from reopening a determination for medical necessity and that CMS provide transparency to the provider community and enrollees in the enforcement activities around non-compliance with the requirements.

The Alliance also recommended that CMS should require Medicare Advantage plans to waive prior authorization requirements for enrollees in need of home health care immediately following an acute or post-acute care facility stay, and that Medicare Advantage plans should be required to reimburse HHAs on an episodic basis, consistent with Traditional Medicare.

The Alliance’s full comments can be found by clicking here.