CMS' Newly Proposed Rule Will Impact DMEPOS Suppliers

CMS has released its CY 2027 Home Health PPS and DMEPOS Proposed Rule, which includes several policy changes that could impact DMEPOS suppliers, in addition to updates affecting home health agencies.

1. The rule proposes routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements.
2. The rule proposes recalibrating the case-mix weights and updating the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2027.
3. The rule discusses the provision of home health palliative care services and includes a request for information (RFI) on a home health specific wage index.
4. The rule also proposes 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.
5. Finally, the rule would:
   1. clarify the application of the DMEPOS face-to-face encounter requirements for the replacement of DMEPOS items
   2. make changes to the provider and supplier enrollment requirements
   3. make changes regarding DME benefit expansion for infusion pumps and drugs
   4. and discuss collection of information requirement changes regarding the DMEPOS Competitive Bidding Program (CBP) country of origin

Stakeholders are welcomed to respond and comment on the proposals until August 31, 2026.

Want to dig deeper? View the full proposed rule here.