Shutdown Ends: What’s Ahead for Aging Services as Government Opens
Putting an end to the country’s historic 43-day government shutdown, late on Wednesday, November 12, President Trump signed into law a spending package that, hours earlier, the House passed by a vote of 222 to 209. The bill, advanced in the Senate on November 10, 2025, extends federal funding for most government programs through January 30 and includes three (of 12) full-year appropriations bills. In addition to funding at fiscal year 2025 levels government programs–including those overseen and administered by the Department of Housing and Urban Development (HUD)–through January 2026, the bill extends Medicare telehealth flexibilities and the acute hospital-at-home program through January 30, 2026. The 4% Medicare sequester cut that would otherwise take effect in calendar year 2026 to offset the cost of HR 1 is waived by this legislation and the Supplemental Nutrition Assistance Program (SNAP) is funded through September 30, 2026.
With the House and Senate now back at work (the House was on recess throughout the shutdown), Congress turns its attention to completing additional full-year appropriations bills, including the fiscal year 2026 funding bill for HUD, and addressing other LeadingAge priorities, such as the permanent extension of telehealth flexibilities and protecting Medicare home health payments from proposed damaging cuts.
LeadingAge Requests CMS to Prioritize Certain Activities Following Shutdown
LeadingAge sent a letter to the Centers for Medicare & Medicaid Services (CMS) on November 13 highlighting a few areas for prioritization as we transition out of the federal government shutdown. Among these concerns, we highlight issues related to respiratory illness guidance and data reporting, survey activities, updates to Care Compare and associated data, and the Civil Money Penalty Reinvestment Program. Read our letter here.
Medicaid Provider Tax Final Rule Goes to OMB for Last Look
On November 17, the Office of Management and Budget (OMB) received the Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole Final Rule. As the final check in the process before the rule is published as final and effective, OMB could provide quick consideration since the proposed rule aligned with changes to state waivers of uniformity included in H.R. 1 section 71117. LeadingAge provided comments on the proposed rule in July. Similarly, on November 14, the Centers for Medicare and Medicaid Services released a ‘dear colleague letter’ on the same provisions showing a seemingly coordinated approach to this topic. LeadingAge will watch for the final rule and keep members updated.
LeadingAge, PAC Coalition Provide CMS Detailed Solutions for Standardizing and Expediting MA Prior Authorizations
LeadingAge, along with its Post Acute Care Coalition partners, shared detailed recommendations with the Center for Medicare and Medicaid Services (CMS) on November 12 for improving the Medicare Advantage (MA) prior authorization processes to better ensure beneficiaries timely access to post-acute care (PAC) services and to reduce the administrative burden on providers from Medicare Advantage (MA) prior authorization (PA) and concurrent review requests. The solutions are in follow up to a July meeting between the coalition and CMS on ensuring that PAC providers benefit from efforts to improve PAs.
The coalition offered two detailed PA solutions to CMS: 1) Require all MA plans to use a standard PA request form (we provide an example); and 2) Require all PAC PA requests to be treated as expedited with plan decisions required within 24 hours. For more background on how the recommendations came about check out the full LeadingAge article and the detailed recommendations we sent to CMS. Our goal is for these solutions to impact the implementation of the Interoperability and Prior Authorization rule to ensure it benefits PAC providers. This paper reflects just one of our advocacy strategies for reducing the administrative burden of PAs on providers and ensuring beneficiaries have more timely access to needed skilled nursing facility and home health services. It supplements comments we’ve already made about how to improve the MA program through standardization and simplification. We continue to support other regulatory changes and legislation to standardize and speed PA decisions.
CMS Posts Home Health Quality and Star Rating Preview Reports for January 2026
Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. With the resumption of government operations on November 13, the HHA Provider Preview Reports updates are now being released in iQIES. These reports contain provider performance scores for quality measures to be published on Care Compare in January 2026. Data contained within the Provider Preview Reports are based on quality assessment data submitted by HHAs from Quarter 2, 2024 through Quarter 1, 2025. The data for the claims-based measures will display data from Quarter 1, 2023 through Quarter 4, 2024 for the Discharge to Community and Medicare Spending Per Beneficiary measures, Quarter 1, 2022 through Quarter 4, 2024 for the Potentially Preventable 30-Day Post-Discharge Readmission measure, and Quarter 1, 2024 through Quarter 4, 2024 for the Home Health Within-Stay Potentially Preventable Hospitalization measure. Additionally, the data for the HHCAHPS measures will display data from Quarter 3, 2024 through Quarter 2, 2025. The Preview Reports for the January 2026 release include one new OASIS-based measure, COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date, based on quality assessment data from Quarter 1, 2025. This measure was proposed for removal in the CY2026 Home Health Rule which has not yet been published.
CMS Posts Hospice Quality Preview Reports for February 2026
Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. With the resumption of government operations on November 13, the Hospice Provider Preview Reports are now being released on CASPER. These reports contain provider performance scores for quality measures to be published on Care Compare in February 2026. In the Provider Preview Reports, assessment-based measure scores are based on HIS data submitted by hospices from Quarter 2, 2024 through Quarter 1, 2025. CAHPS measure scores are based on CAHPS data submitted from Quarter 2, 2023 through Quarter 1, 2025. CAHPS Star Ratings are calculated based on data from Quarter 2, 2023 through Quarter 1, 2025. The claims-based measures reflect claims data collected from Quarter 1, 2023 through Quarter 4, 2024.
OIG Looking at Nursing Home Quality After Changes in Ownership
The Department of Health & Human Services (HHS) Office of Inspector General (OIG) updated its current workplan on November 17 to include a new nursing home item. OIG will be investigating how the Centers for Medicare & Medicaid Services (CMS) and state survey agencies identify and respond to declines in nursing home quality following changes in ownership. The report is expected in fiscal year 2027 and is the latest in more than a dozen work plan tasks focused on nursing homes. Review OIG’s current work plan here.
