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House Releases Text of a Short-Term Continuing Resolution (CR)
On September 16, the House Appropriations Committee released the text of a short-term continuing resolution that would fund the government and extend expiring health programs through November 21, 2025. This CR is expected to be voted on in the House in the coming days but will not receive bipartisan support. The Democrats are planning to release their own CR proposal in the coming days. More details on what is contained in the bill released today can be found in this LeadingAge article.
OIG Adds Medicare Advantage Enrollment Manipulation Schemes to Their Work Plan
On September 16, the Office of Inspector General added a new item to their work plan which will look at “schemes” of improper influencing Medicare Advantage (MA) enrollment. Examples highlighted in the announcement include enrolling beneficiaries into MA plans without their consent, structuring incentive payments to agents to minimize enrollment of people with disabilities, and paying kickbacks to providers in exchange for enrollments. OIG acknowledges to date, enrollment manipulation schemes have been identified primarily through whistleblowers, with minimal visibility into schemes that go unreported. To address this gap, OIG will conduct a large-scale analysis of enrollment and disenrollment data to identify aberrant patterns that may signal improper MAO actions to influence enrollment.
LeadingAge Says 3-Day Stay Must End to Preserve Access to SNF
LeadingAge submitted comments to CMS on September 15 on the hospital outpatient prospective payment rule (CMS-1834-P) related to a proposal which would completely phase out the procedures on the Inpatient Only List over the next three years. We highlighted that this shift could remove access to skilled nursing facility (SNF) services that have often followed many of these procedures, and especially the musculoskeletal procedures proposed for elimination in 2026. Without a 3-day inpatient hospital stay, Medicare fee-for service (FFS) beneficiaries would no longer be able to receive skilled care or rehabilitative therapies in a SNF, and have those services paid by Medicare. LeadingAge members reported that roughly 20-50% of their admissions currently are for musculoskeletal procedures that would be impacted by the rule change. Therefore, we proposed CMS pursue eliminating the 3-day stay requirement and in the interim, exempt any procedures removed from the Inpatient Only List from requiring a 3-day hospital stay in order to preserve access to SNF services post-procedure. We also encouraged CMS to reimagine how SNFs could play a key role in reducing Medicare costs for individuals with chronic conditions that need additional short-term support to manage their condition. Our full comment letter can be found here.
Ask Your Representatives to Protect Nonprofit Home Health Care
The Calendar Year 2026 (CY26) Home Health Payment System Rate Update proposes a 9% decrease in Medicare Fee-for-Service payments, the largest reduction in the past decade that also follows consecutive cuts in each of the past three years by the Center for Medicare and Medicaid Services (CMS). The result: agencies are closing and reducing service areas and home health patients are getting fewer visits and waiting longer to start care. The bipartisan Home Health Stabilization Act of 2025 (H.R. 5142) introduced by Representatives Kevin Hern (R-OK) and Terri Sewell (D-AL) seeks to delay these cuts by two years and allow stakeholders time to address issues in the current payment system that are devastating providers. Join LeadingAge to protect our nation’s home health infrastructure and older adults’ access to care across the continuum.
