Wednesday, December 3, 2025

 Official Publication of Minnesota Home Care Association

  Inside the Informer

  Member News

CY2026 Home Health Final Rule

Late Friday afternoon the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2026 Home Health Prospective Payment System Rate and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates. In past years, CMS published the HH Final Rule on or about November 1. The HH Final Rule was delayed this year due to the government shutdown.

Here are a few highlights:

• The aggregated payment update for 2026 results in a net decrease of 1.3%.

• Face-to-face rules are expanded so that NPs, CNSs, PAs, and physicians may conduct encounters regardless of whether they are the certifying practitioner.

• CMS is revising HHVBP by removing three HHCAHPS-based measures, adding four new measures, and updating measure weights, while also adding a new criterion for removing quality measures.

More information is available in our blast that was sent out yesterday, linked here.

Medicare Reimbursement Webinar 1/22/26

Numerous factors contribute to the calculation of Medicare reimbursement under the Patient Driven Groupings Model (PDGM), as well as various other programs that can also impact reimbursement:

• Home Health Value-Based Purchasing (HHVBP),

• Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), and

• Home Health Quality Reporting Program (HHQRP)

This session will review the details of these programs and how they directly impact reimbursement for home health agencies.

Register here.

2026 Hot Topics Registration is Open!

Please re-register for the 2026 Hot Topics so you can choose the topics applicable to you. Please reach out to education@mnhomecare.org with any questions.

2026 Emergency Tabletop Exercise: Safety and Workplace Violence

This exercise consists of three short scenarios:

• An event/emergency in the community that impacts access to/from service area.

• Violent threat in the home office.

• Verbally or physically aggressive person in the home.

Who should attend? Leadership, HR/Personnel Manager, Nurse Leaders, Clinicians, Office Staff, Field Staff, Front Desk Receptionist and anyone else who would benefit from safety education.

Register here.

  MHCA IN ACTION

Minnesota Leadership Council on Aging’s 2025 Summit

Leaders are stepping forward to shape what comes next for our state’s aging sector. The conversations are personal. The challenges are complex. The need for changemakers with a diversity of vantage points in our community has never been greater.

You are invited to join the Minnesota Home Care Association at the Summit, where you will connect with voices from every corner of Minnesota to ask bold questions, explore powerful solutions, and build momentum for collective action. Register now to attend the 2025 Summit:

• Virtual Day - December 10 (11 a.m. – 2 p.m.) via Zoom

• In-Person Day - December 16 (9 a.m. – 2 p.m.) at St. Catherine University

Learn more: https://www.mnlcoa.org/2025Summit

Register now: https://www.zeffy.com/ticketing/2025-summit

  MEMBER CORNER

Don’t Forget to Renew Your MHCA Membership!

Renew your membership today to maintain uninterrupted access to our education, advocacy, and support throughout 2026.

Log in to your agency account and click the “Renew Your Membership Here” button.

If you have any questions, please contact lpause@mnhomecare.org.

 Compliance corner

Data Refresh of HH QRP Available

Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. Now that government operations have resumed as of November 13, these updates are being released.

Effective November 20, 2025, the October 2025 HH QRP refresh is available on the Compare tool on Medicare.gov and in the Provider Data Catalog (PDC).

This update reflects quality assessment data submitted by HHAs to the Centers for Medicare & Medicaid Services (CMS) for Quarter 1 through Quarter 4 of 2024.

  State news

DHS Roundtable Information on Prepayment Review Process

DHS has shared information surrounding the prepayment review process at their November roundtable discussion. The link provided here includes the slides from the meeting and information on how Optum will be used for auditing.  The state agency also launched a new website to add transparency in the work they are doing to prevent fraud. It details how they are strengthening fraud prevention, detection, and enforcement by providing:

• Clear definitions for fraud, waste and abuse

• A timeline of actions taken

• Key decisions made that support transparency, prevention, detection and enforcement

• Information on preliminary investigations, cases opened, law enforcement referrals and administrative actions.

Reminder: Minneapolis Minimum Wage Increase

The Minneapolis minimum wage will be increased to $16.37 in 2026 to adjust for inflation. These changes will take effect on January 1.

DHS Resources Webpage for Federal Changes

The Minnesota Department of Human Services (DHS) has a webpage that provides information and resources about the federal changes for Medicaid. The webpage can be accessed here.

Minnesota Eligibility Policy Manual Updates

The Minnesota Eligibility Policy Manual (EPM) has an update to the following sections:

2.3.1.2 MA-ABD Asset Verification Service (AVS)

DHS clarified that individuals with 1619(a) or 1619(b) status are not required to have a valid DHS-7823 form on file or an AVS ad-hoc request run at application or renewal.

2.3.3.2.8 MA-ABD Asset Verification

Bulletin 24-21-04 DHS Clarifies Minnesota Health Care Programs Income and Asset Verification Policies for Certain People is now incorporated into this new EPM section.

Appendix F Standards and Guidelines

DHS revised the following standards and guidelines that become effective January 1, 2026.

• Clothing and Personal Needs Allowance

• Pickle Disregard

• Remedial Care Expense

• Special Income Standard

• Supplemental Security Income Maximum Payment Amount

  federal news

Is Nursing a Professional Degree?

One of the components of H.R. 1, otherwise known as the Big Beautiful Bill, included narrowing the definition of a “professional” degree and therefore eligibility for loans. The Department of Education has drafted regulatory language that will apply to new borrowers starting July 1, 2026. The Minnesota Home Care Association (MHCA) fully recognizes that nurses are professionals and should not be excluded from loans. In addition to the disrespect reflected in this proposal, this is alarming for home health and other healthcare providers, as it comes in the midst of a critical shortage of nurses.

There is a process that needs to be followed before this change would be implemented, including:

1. Public Comment Period: There will be a period (in the coming months) for the public, including individuals, universities, and healthcare organizations, to submit formal comments and objections to the proposed definition of a professional degree.

2. Review of Comments: The Department of Education is required to review and consider all comments received during this period.

3. Final Rule: After reviewing the public comments, the Department of Education will issue a final rule, which may include adjustments based on the feedback.

4. Implementation: The final rule will take effect for new student loan borrowers starting July 1, 2026.

MHCA is following this closely and will collaborate with the National Alliance for Care at Home on advocacy efforts to block this proposed change.

CMS Releases CIB on H.R.1 Provisions that Impact Medicaid

The Centers for Medicare & Medicaid Services (CMS) released a Center Informational Bulletin (CIB) on November 19 that summarizes the provisions within H.R.1 that impact Medicaid. The bulletin does not offer new details on CMS’s implementation plans; rather, it serves as a comprehensive reference for all the different H.R.1 provisions that impact the Medicaid program. Most notably, it includes a table that outlines all of the different effective dates of the legislation provisions. Please see the copy of the table for information. 

  Educational Opportunities

MHCA Partnerships

Fueled Growth Partners is a company that provides a net zero cost supplemental health care plan with amazing benefits, while providing revenue to MHCA. Attend one of their webinars to learn more!

December 16, 2025 - The Future of Healthcare at Net ZERO Cost, Webinar

Fueled Growth Partnership 

On-Demand Opportunities

Click on the logos below for a list of courses offered!

Save the Date

• December 3, 2025 – Member Meeting + Free Education: Ask About Pets! – A Training for Home Care Staff & Organizations, Virtual

Minnesota Home Care Association
P: 651.635.0607  |  F: 651.635.0043  |  www.mnhomecare.org  |  membership@mnhomecare.org

STAY CONNECTED

Mission: MHCA represents and supports Minnesota home care providers committed to high quality home care services.
Vision: MHCA will shape the home care landscape to improve and sustain quality home care services.