CY 2027 Home Health Proposed Rule: Payment, Quality Reporting and DMEPOS Changes to Check

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule in the Federal Register on July 6, 2026. It covers Medicare home health payment for calendar year (CY) 2027 and several durable medical equipment and enrollment policies ^[1].

What the document is

The rule is Federal Register document 2026-13602. It was issued by the Department of Health and Human Services through CMS and is classified as a proposed rule ^[1]. Its title spans four areas ^[1]:

• the CY 2027 Home Health Prospective Payment System (HH PPS) rate update ^[1];
• requirements for the Home Health Quality Reporting Program (HH QRP) and the expanded Home Health Value-Based Purchasing (HHVBP) Model ^[1];
• Medicare provider enrollment ^[1];
• policies for durable medical equipment (DME) and for DME, prosthetics, orthotics, and supplies (DMEPOS) ^[1].

Proposed home health payment changes

CMS describes the rate changes as routine updates to Medicare home health payment, made as existing statute and regulation require ^[1]. Beyond the base update, the rule discusses the behavior adjustment and proposes a temporary one ^[1]. It also proposes recalibrated case-mix weights and CY 2027 updates to functional impairment levels, comorbidity subgroups and low-utilization payment adjustment (LUPA) thresholds ^[1]. The source summary gives no percentages, dollar amounts or threshold values, so the size of these changes cannot be reported here ^[1].

Palliative care and a wage index request

The rule discusses the provision of home health palliative care services ^[1]. It also includes a request for information (RFI), a formal invitation for public input, on a wage index specific to home health ^[1].

Quality reporting and value-based purchasing

The rule proposes changes to the HH QRP ^[1]. It also summarizes potential initiatives for improving alignment between the HH QRP and the expanded HHVBP Model ^[1]. The summary does not list which measures or reporting requirements would change, so that detail sits in the full text of the document ^[1].

DME, DMEPOS and enrollment provisions

The final group of provisions addresses DMEPOS, the DME benefit and Medicare enrollment ^[1]. The rule would:

• clarify how the DMEPOS face-to-face encounter requirements apply to the replacement of DMEPOS items ^[1];
• make changes to enrollment requirements for providers and suppliers ^[1];
• make changes regarding DME benefit expansion for infusion pumps and drugs ^[1];
• discuss changes to collection of information requirements regarding country of origin in the DMEPOS Competitive Bidding Program (CBP) ^[1].

Which programs it reaches

The payment and wage index provisions concern Medicare home health payment, and the palliative care discussion concerns home health services ^[1]. The quality provisions concern the HH QRP and the expanded HHVBP Model ^[1]. The enrollment provisions are framed as changes to provider and supplier enrollment requirements ^[1]. The remaining provisions concern DMEPOS replacements, DME benefit expansion for infusion pumps and drugs, and the DMEPOS CBP ^[1]. The source summary does not name affected organizations beyond these programs, so readers should match their own role against the program list ^[1].

Dates that matter

The proposed rule was published on July 6, 2026, and its rate update and LUPA threshold provisions are written for CY 2027 ^[1]. The source summary does not state a public comment deadline or a date for a final rule, so neither is given here ^[1]. The provisions described above are proposals, not final policy ^[1].

What a practice should check

• Home health agencies can review the proposed temporary behavior adjustment, recalibrated case-mix weights, functional impairment levels, comorbidity subgroups and LUPA thresholds in the full text ^[1].
• Agencies that provide or plan to provide palliative care can read CMS's discussion of home health palliative care services ^[1].
• Quality staff can identify which HH QRP changes are proposed and which alignment initiatives with the expanded HHVBP Model CMS summarizes ^[1].
• Staff who handle DMEPOS replacements can read how CMS proposes to clarify the face-to-face encounter requirements for those items ^[1].
• Medicare-enrolled providers and suppliers can check whether the proposed enrollment changes apply to them ^[1].
• Suppliers of infusion pumps and related drugs, and suppliers in the CBP, can review the provisions on DME benefit expansion and country-of-origin information collection ^[1].
• All readers can confirm in the Federal Register whether a final rule has followed proposed document 2026-13602 ^[1].