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

> CMS's proposed CY 2027 home health rule would update payment rates, propose a temporary behavior adjustment, change quality reporting, and revise DMEPOS and enrollment policies. Here is what it covers and what to verify.

SmartMeet Desk · 2026-10-12 · https://blog.smartmeet.cloud/cy-2027-home-health-proposed-rule-payment-quality-reporting-and-dmepos-changes-t

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].

## References

1. federalregister.gov. Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies. Accessed October 11, 2026. https://www.federalregister.gov/documents/2026/07/06/2026-13602/calendar-year-2027-home-health-prospective-payment-system-hh-pps-rate-update-requirements-for-the-hh