Introduced in House — H.R. 5142

119th CONGRESS

1st Session

H. R. 5142

IN THE HOUSE OF REPRESENTATIVES

September 4, 2025

Mr. Hern of Oklahoma (for himself and Ms. Sewell) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to ensure stability in payments to home health agencies under the Medicare program.

Section 1. Short title

This Act may be cited as the Home Health Stabilization Act of 2025.

Sec. 2. Ensuring beneficiary access to Medicare home health services

(a) Delaying adjustments

Section 1895(b)(3)(D) of the Social Security Act (42 U.S.C. 1395fff(b)(3)(D)) is amended by adding at the end the following new clauses:

(iv) Special rule for 2026 and 2027
For 2026 and 2027, the Secretary shall provide for a positive adjustment to the standard prospective payment amount to fully offset the –4.059 percent Permanent Adjustment Factor and the –5.0 percent Temporary Adjustment Factor applied to the calendar year 2026 national, standardized 30-day period payment rate in the proposed rule entitled, Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies published in the Federal Register on July 2, 2025 (90 Fed. Reg. 29108). Notwithstanding any other provision of law, the Secretary may implement this clause by program instruction or otherwise.
(v) Special rule for 2026 and 2027
For 2026 and 2027, the Secretary shall establish the national, standardized 30-day period payment rate based on the 2025 rate, taking into account the adjustment under clause (iv) and updated based on all other provisions of this section, except that such rate for 2026 or 2027 shall not be further adjusted based on clause (ii) or clause (iii).
(vi) Exception
In determining actual expenditures under clause (i) for 2026 and 2027 the Secretary shall exclude the additional amounts paid as a result of clauses (iv) and (v), and no adjustments under clause (ii) or clause (iii) shall be made to offset for such amounts.

(b) Construction

Nothing in this section shall be construed as signifying congressional approval or disapproval of the methodology promulgated by the Secretary to implement section 1895(b)(3)(D) of the Social Security Act in the final rule entitled, Medicare Program; Calendar Year (CY) 2023 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements; Home Health Value-Based Purchasing Expanded Model Requirements; and Home Infusion Therapy Services Requirements published in the Federal Register on November 4, 2022 (87 Fed. Reg. 66790).