{"abstract":"This final rule sets forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this final rule discusses the behavior adjustments and finalizes a temporary behavior adjustment. It also finalizes the recalibrated case-mix weights and updated functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2027. Additionally, this final rule discusses and responds to comments on the provision of home health palliative care services and includes a summary of comments received on the request for information (RFI) on a home health specific wage index included in the proposed rule. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and expanded Home Health Value- Based Purchasing (HHVBP) Model. Lastly, the rule clarifies the application of the DMEPOS face-to- face encounter requirements for the replacement of DMEPOS items; makes changes to the provider and supplier enrollment requirements; makes changes to implement a DME benefit expansion for infusion pumps and drugs; and discusses collection of information requirement changes regarding the DMEPOS Competitive Bidding Program (CBP) country of origin.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2026/11/09/2026-22750.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"405","title":42},{"chapter":null,"citation_url":null,"part":"410","title":42},{"chapter":null,"citation_url":null,"part":"414","title":42},{"chapter":null,"citation_url":null,"part":"422","title":42},{"chapter":null,"citation_url":null,"part":"423","title":42},{"chapter":null,"citation_url":null,"part":"424","title":42},{"chapter":null,"citation_url":null,"part":"484","title":42},{"chapter":null,"citation_url":null,"part":"498","title":42}],"citation":"91 FR 72022","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"With the exception of the HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245, these regulations are effective on January 4, 2026. The HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245 are effective January 1, 2027.","disposition_notes":null,"docket_ids":["CMS-1844-F"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":0,"comment_start_date":"2026-11-09","updated_at":"2026-11-10T09:58:31.945-05:00","comment_url":"https://www.regulations.gov/commenton/CMS-2026-2311-0431","allow_late_comments":false,"id":"CMS-2026-2311-0431","comment_end_date":null,"regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2026-2311","title":"CY 2027 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Payment Update (CMS-1844-P)"}],"document_number":"2026-22750","effective_on":"2026-01-04","end_page":72173,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2026/11/09/2026-22750.xml","html_url":"https://www.federalregister.gov/documents/2026/11/09/2026-22750/calendar-year-2027-home-health-prospective-payment-system-hh-pps-rate-update-requirements-for-the-hh","images":{"ER09NO26.019":{"large":"https://img.federalregister.gov/ER09NO26.019/ER09NO26.019_large.png","medium":"https://img.federalregister.gov/ER09NO26.019/ER09NO26.019_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.019/ER09NO26.019_original_size.png"},"ER09NO26.018":{"large":"https://img.federalregister.gov/ER09NO26.018/ER09NO26.018_large.png","medium":"https://img.federalregister.gov/ER09NO26.018/ER09NO26.018_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.018/ER09NO26.018_original_size.png"},"ER09NO26.015":{"large":"https://img.federalregister.gov/ER09NO26.015/ER09NO26.015_large.png","medium":"https://img.federalregister.gov/ER09NO26.015/ER09NO26.015_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.015/ER09NO26.015_original_size.png"},"ER09NO26.037":{"large":"https://img.federalregister.gov/ER09NO26.037/ER09NO26.037_large.png","medium":"https://img.federalregister.gov/ER09NO26.037/ER09NO26.037_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.037/ER09NO26.037_original_size.png"},"ER09NO26.014":{"large":"https://img.federalregister.gov/ER09NO26.014/ER09NO26.014_large.png","medium":"https://img.federalregister.gov/ER09NO26.014/ER09NO26.014_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.014/ER09NO26.014_original_size.png"},"ER09NO26.036":{"large":"https://img.federalregister.gov/ER09NO26.036/ER09NO26.036_large.png","medium":"https://img.federalregister.gov/ER09NO26.036/ER09NO26.036_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.036/ER09NO26.036_original_size.png"},"ER09NO26.017":{"large":"https://img.federalregister.gov/ER09NO26.017/ER09NO26.017_large.png","medium":"https://img.federalregister.gov/ER09NO26.017/ER09NO26.017_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.017/ER09NO26.017_original_size.png"},"ER09NO26.039":{"large":"https://img.federalregister.gov/ER09NO26.039/ER09NO26.039_large.png","medium":"https://img.federalregister.gov/ER09NO26.039/ER09NO26.039_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.039/ER09NO26.039_original_size.png"},"ER09NO26.016":{"large":"https://img.federalregister.gov/ER09NO26.016/ER09NO26.016_large.png","medium":"https://img.federalregister.gov/ER09NO26.016/ER09NO26.016_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.016/ER09NO26.016_original_size.png"},"ER09NO26.038":{"large":"https://img.federalregister.gov/ER09NO26.038/ER09NO26.038_large.png","medium":"https://img.federalregister.gov/ER09NO26.038/ER09NO26.038_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.038/ER09NO26.038_original_size.png"},"ER09NO26.000":{"large":"https://img.federalregister.gov/ER09NO26.000/ER09NO26.000_large.png","medium":"https://img.federalregister.gov/ER09NO26.000/ER09NO26.000_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.000/ER09NO26.000_original_size.png"},"ER09NO26.022":{"large":"https://img.federalregister.gov/ER09NO26.022/ER09NO26.022_large.png","medium":"https://img.federalregister.gov/ER09NO26.022/ER09NO26.022_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.022/ER09NO26.022_original_size.png"},"ER09NO26.021":{"large":"https://img.federalregister.gov/ER09NO26.021/ER09NO26.021_large.png","medium":"https://img.federalregister.gov/ER09NO26.021/ER09NO26.021_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.021/ER09NO26.021_original_size.png"},"ER09NO26.002":{"large":"https://img.federalregister.gov/ER09NO26.002/ER09NO26.002_large.png","medium":"https://img.federalregister.gov/ER09NO26.002/ER09NO26.002_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.002/ER09NO26.002_original_size.png"},"ER09NO26.024":{"large":"https://img.federalregister.gov/ER09NO26.024/ER09NO26.024_large.png","medium":"https://img.federalregister.gov/ER09NO26.024/ER09NO26.024_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.024/ER09NO26.024_original_size.png"},"ER09NO26.001":{"large":"https://img.federalregister.gov/ER09NO26.001/ER09NO26.001_large.png","medium":"https://img.federalregister.gov/ER09NO26.001/ER09NO26.001_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.001/ER09NO26.001_original_size.png"},"ER09NO26.023":{"large":"https://img.federalregister.gov/ER09NO26.023/ER09NO26.023_large.png","medium":"https://img.federalregister.gov/ER09NO26.023/ER09NO26.023_medium.png","original_size":"https://img.federalregister.gov/ER09NO26.023/ER09NO26.023_orig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