Deregulation Rule at OMB
A new proposed rule appeared on the Office of Management and Budget’s (OMB’s) regulatory dashboard, Office of Information and Regulatory Affairs (OIRA) on July 2. Cutting Administrative Requirement for Excellence in Patient Care is under review, the final step prior to being released to the Federal Register. While the text of the rule will not be available until the rule is released, the abstract describes the rule as “modernizing the Conditions of Participation, Conditions for Coverage, and Requirements for Medicare- and Medicaid-participating providers and suppliers, reducing burden, and increasing flexibility to deliver high quality care.” It is expected that this rule will be based on responses to OMB’s and the Department of Health and Human Services’ (HHS’) Requests for Information on deregulation in spring 2025 – review LeadingAge’s recommendations here: OMB and HHS. There is no guarantee, however, what stakeholder recommendations were considered for this rule. Similarly, there is no specific timeline for when this rule might be released to the Federal Register. LeadingAge will be closely monitoring for and updating members on any developments.
21st Century ROAD to Housing Becomes Law
The 21st Century ROAD to Housing became law Friday, July 10 after being briefly held up in its final stages. The bill was passed by Congress on June 23 after months of negotiations in both chambers. President Trump had been expected to sign the bill into law but cancelled the scheduled signing of the bill to bring attention to a separate legislative priority that had stalled. The bill became law on July 10 without President Trump’s signature based on Constitutional law that stipulates a president has ten days to sign or veto bills passed by Congress and presented to the president. If the president does not take action to veto the legislation within 10 days and Congress is in session at the 10-day mark, the bill becomes law even without the president’s endorsement. The 21st Century ROAD to Housing Act is the first piece of major housing legislation passed in over a decade. It does not enact any new funding for housing programs, but instead reforms and modernizes existing housing rules. LeadingAge worked closely with Congress on a number of provisions and views this legislation as a step in the right direction toward addressing the nation’s housing crisis. Learn more here.
Recent HHS OIG Advisory Opinion On Electronic Referral Systems
On June 30, 2026, the Department of Health and Human Services’ Office of Inspector General (OIG) issued Advisory Opinion No. 26-15 finding that a home health agency operator’s subscription payment to a vendor of electronic referral system software raises anti-kickback concerns. HHS OIG found, in part, that the arrangement afforded to subscribers of the electronic referral system software poses a risk of inappropriate steering and unfair competition due to the significant competitive advantage that subscribers have over nonsubscribers in being able to electronically receive and accept home health referrals. HHS OIG also found that the anti-competitive effect is further exacerbated for home health agencies that cannot afford the subscription, and therefore, it appeared that the subscribers were getting patients based on their ability to pay for the subscription, as opposed to the quality of their services. Although an advisory opinion is limited to the specific facts set forth by the party requesting the opinion, it can be instructive for other providers. Please see the article for more information.
Senate Passes OAA Reauthorization
On July 14, the Senate passed S. 2120 the Older Americans Act (OAA) Reauthorization Act of 2025, sponsored by Senator Bill Cassidy (R-LA). The bill would reauthorize the OAA through 2030 and provide for grants and services to provide counseling, supportive services, home-delivered meals, and fund programs to prevent elder abuse, neglect, and exploitation. Many of our members and the people they serve rely on these funds and services. Reauthorization stabilizes funding for the programs within OAA and demonstrates a commitment to older adults. The bill will now move to the House.
PBJ Reporting Transitions to iQIES in August
The Centers for Medicare & Medicaid Services (CMS) released memo QSO-26-12-NH on July 14 announcing that payroll-based journal (PBJ) reporting will transition to iQIES beginning with Fiscal Quarter 4 reporting. Nursing homes must continue to submit Fiscal Quarter 3 reports through QIES before the August 14 deadline. After August 14 at 11:59pm ET, QIES will no longer accept PBJ records and all reporting will be completed through iQIES beginning August 17, 2026. CMS notes that due to this transition, Fiscal Quarter 4 submissions will not be accepted in either system – QIES or iQIES – between July 1, 2026 and August 16, 2026.
To submit records through iQIES, providers must request access through their HCQIS Access Roles and Profile System (HARP) account. Note that third-party vendors submitting PBJ data on behalf of providers must request access through HARP for each individual nursing home they represent. Once registered for iQIES, users should log in regularly, as accounts that are not accessed for 60 days will be determined inactive and the user will lose access to iQIES.
Following the transition from QIES to iQIES, PBJ reports in the Certification and Survey Provider Enhanced Reporting (CASPER) application will be decommissioned and transitioned to iQIES. Providers will be able to access only two PBJ reports for Fiscal Quarter 3 through CASPER: the system-generated final validation reports and the user-requested PBJ Submitter Final Validation Report. These reports will be available for Fiscal Quarter 3 reporting for a limited time only. Beginning August 17, users will use iQIES to access and run PBJ reports previously accessed through CASPER. CMS provides a crosswalk in memo QSO-26-12-NH to help providers identify the legacy CASPER reports in the new iQIES system, including the names of the reports in each system and any differences of which users should be aware. CMS will additionally be importing ten years’ worth of data into iQIES to allow users to run reports on data previously submitted through QIES. CMS will be posting training materials, user guides, and technical guidance on the QIES Technical Support Office (QTSO) website prior to the August 17 transition to assist providers.
Updates to Quality Measure Thresholds Are Back
The Centers for Medicare & Medicaid Services (CMS) has updated the Five Star Quality Rating System Technical Users’ Guide to reflect changes to ratings thresholds for the Quality Measures domain, expected with the quarterly refresh scheduled for July 29. These changes are based on a policy change dating back to March 2019 when CMS announced that they would begin doing regular updates every six months. The policy states that Quality Measure domain rating thresholds will be updated every six months at a rate of half the previous cycle’s rate of improvement. Ratings thresholds for individual quality measures within the domain are not impacted by this policy. Prior to the implementation of this policy, threshold updates were made without regularity, often resulting in more significant changes than CMS anticipated more regular updates would provide. Additionally, CMS noted that regular updates would incentivize continuous quality improvement. The policy has not been implemented often over the seven years since it was announced, though it remained in effect. The policy was suspended for a period of time during the COVID-19 public health emergency, then later performance did not allow for the types of threshold updates described in the policy. An update was implemented in January 2025 and ratings have steadily improved since that time, resulting in the conditions to once again apply this policy with the July 2026 refresh. Assuming performance continues in this trend, nursing homes can expect another adjustment to Quality Measure domain rating thresholds in January 2027. The LeadingAge Report Portal will be updated following the release of the July quarterly refresh data and will reflect the domain rating threshold changes.
Weekly Recaps: July 15, 2026
- Affordable Housing Weekly Recap. Here is your Affordable Housing Weekly Recap.
- Home Health Weekly Recap. Here is your Home Health Weekly Recap.
- Hospice Weekly Recap. Here is your Hospice Weekly Recap.
- Life Plan Community Weekly Recap. Here is your Life Plan Community Weekly Recap.
- Medicaid, HCBS, and PACE Weekly Recap. Here is your Medicaid, HCBS, and PACE Weekly Recap.
- Nursing Home Weekly Recap. Here is your Nursing Home Weekly Recap.
- Workforce Policy Weekly Recap. Here is your Workforce Policy Weekly Recap.
