CMS proposes Medicare eligibility changes and home health rate updates

The Centers for Medicare & Medicaid Services (CMS) has released proposed rules for the Calendar Year 2027 that impact both home health payment rates and Medicare eligibility requirements.

The National Alliance for Care at Home has submitted comments regarding the Home Health Prospective Payment System. While the Alliance noted that CMS is proposing a full annual payment update for the first time since 2022, it warned that this does not offset the significant harm caused by years of permanent adjustments. The Alliance estimates these adjustments will result in aggregate reductions of $18.9 billion between 2020 and 2030, potentially threatening access to care.

Additionally, CMS has proposed changes to Medicare eligibility for lawfully present immigrants following the Budget Reconciliation Act of 2025. Under the new rules, Medicare eligibility would be restricted to U.S. citizens, U.S. nationals, Lawful Permanent Residents, certain Cuban or Haitian entrants, and individuals under the Compact of Free Association. Other groups, including refugees, asylees, and those with Temporary Protected Status, would no longer be eligible for Medicare, though they may remain eligible for other Social Security benefits.