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LTC Update | Aug 7, 2026

Date postedAugust 7, 2026

SDAHO 

  • Registration is now open for SDAHO's 100th Annual Convention, taking place September 16–18, 2026, at the Sioux Falls Convention Center.

    This year's convention marks a historic milestone as we celebrate a century of serving South Dakota's healthcare community. Under the theme "A Century Strong: Honoring Our Past, Shaping Our Future," we will reflect on our rich history while exploring the opportunities and challenges that lie ahead for healthcare across our state.

    To learn more or to register, click here.

 

STATE

  • (NEW) South Dakota Healthcare Preparedness Coalition Newsletter.  Here’s this week’s HPC Newsletter!

 

SNF

  • (NEW) Analysis of FY 2027 SNF PPS Final Rule. The Centers for Medicare & Medicaid Services (CMS) finalized the Fiscal Year 2027 Skilled Nursing Facilities Prospective Payment System rule on July 29. The rule was finalized mostly as proposed with a 2.4% payment update for SNFs in fiscal year 2027, the removal of two measures from the SNF Quality Reporting Program, and changes to data submission timelines and requirements for SNF QRP and SNF Value-based Purchasing. Read the details here.

  • (NEW SNF AND HOSPICE) CMS Releases Non-Compliance Letters for Quality Reporting Programs. The Centers for Medicare & Medicaid Services (CMS) released notifications on August 5 notifying providers that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2025, which will affect their FY 2027 Annual Payment Update (APU). Non-compliance notifications were sent to providers’ My Reports folders in the Internet Quality Improvement and Evaluation System (iQIES), for Hospices and SNFs on August 5 and are additionally being distributed by the Medicare Administrative Contractors (MACs). Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, September 4, 2026.

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the appropriate QRP webpage:

SNF Quality Reporting Reconsideration and Exception & Extension

Hospice Quality Reporting Reconsideration Requests

 

HOME HEALTH

  • (NEW) Senator Collins Introduces Medicare Home Health Payment Integrity and Protection Act of 2026. LeadingAge is pleased to support "The Medicare Home Health Payment Integrity and Protection Act of 2026,” S 5250, introduced by Senator Susan Collins (R-ME) on August 5. This bill would implement targeted program integrity provisions in home health that mirror those in Rep. Beth Van Duyne's (R-TX) HR 8883 "Protecting Seniors and Stopping Fraudsters Act." The bill would also eliminate all permanent and temporary adjustments to the standard prospective payment rate resulting in a much needed reset of the home health rate after years of cuts.

  • (NEW) CMS Releases Home Health Agency PEPPER Reports. The Centers for Medicare and Medicaid Services (CMS) released the 2025 Program for Evaluating Payment Patterns Electronic Report (PEPPER) for home health agencies. Unlike hospice PEPPER reports, CMS did not change the home health reports. These reports are intended to help agencies review billing data to make sure claims are accurate. Home health agencies can use the reports to spot billing patterns that may need review or improvement. It can identify areas that may need closer monitoring or internal audits. Agencies can find services that may be under-coded or over-coded. It can also help track trends like longer patient stays.
  • (NEW) National Healthcare at Home Best Practices Study. We're reaching out to encourage all home health and hospice agency leaders to participate in the National Healthcare at Home Best Practices Study.  Having data is critical for healthcare at home providers as we move forward with new value-based initiatives and stricter regulations. This critical initiative is well worth 20-minutes of your time!

If you've already signed up: You should have received a survey link via email. Links and reminders are sent every Tuesday, so please check your inbox (and spam folder) if you haven't seen yours.

If you haven't signed up yet or don't know if you've signed up: Please complete the study survey at

Home Health Survey: https://mst.qualtrics.com/jfe/form/SV_bBeJZxizdTLMODs

Important details:

    • Deadline to participate: August 31, 2026
    • Only participating agencies will receive the aggregate results from the study.  If we have enough participants from our state we will also receive special data comparing our state to others.

This research is being conducted by Missouri University of Science and Technology and is sponsored by:

    • National Alliance for Care at Home
    • LeadingAge
    • Nationwide State Home Health and Hospice Associations
    • HealthPivots is serving as the national data sponsor.

This is a valuable opportunity to benchmark your agency's practices against peers nationally and gain insights that can help shape future strategy. We encourage you to participate today to ensure your agency's voice is heard.

HOSPICE

  • (NEW SNF AND HOSPICE) CMS Releases Non-Compliance Letters for Quality Reporting Programs. The Centers for Medicare & Medicaid Services (CMS) released notifications on August 5 notifying providers that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2025, which will affect their FY 2027 Annual Payment Update (APU). Non-compliance notifications were sent to providers’ My Reports folders in the Internet Quality Improvement and Evaluation System (iQIES), for Hospices and SNFs on August 5 and are additionally being distributed by the Medicare Administrative Contractors (MACs). Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, September 4, 2026.

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the appropriate QRP webpage:

SNF Quality Reporting Reconsideration and Exception & Extension

Hospice Quality Reporting Reconsideration Requests

  • (NEW) We're reaching out to encourage all home health and hospice agency leaders to participate in the National Healthcare at Home Best Practices Study.  Having data is critical for healthcare at home providers as we move forward with new value-based initiatives and stricter regulations.  This critical initiative is well worth 20-minutes of your time!

If you've already signed up: You should have received a survey link via email. Links and reminders are sent every Tuesday, so please check your inbox (and spam folder) if you haven't seen yours.

If you haven't signed up yet or don't know if you've signed up: Please complete the study survey at:

Hospice Survey: https://mst.qualtrics.com/jfe/form/SV_3C03bpDEc5bM9Jc

Important details:

    • Deadline to participate: August 31, 2026
    • Only participating agencies will receive the aggregate results from the study.  If we have enough participants from our state we will also receive special data comparing our state to others.

This research is being conducted by Missouri University of Science and Technology and is sponsored by:

    • National Alliance for Care at Home
    • LeadingAge
    • Nationwide State Home Health and Hospice Associations
    • HealthPivots is serving as the national data sponsor.

This is a valuable opportunity to benchmark your agency's practices against peers nationally and gain insights that can help shape future strategy. We encourage you to participate today to ensure your agency's voice is heard.

 

LeadingAge – Must be a member to access resources 

  • National Policy Pulse Call. LeadingAge’s members-only briefing and analysis call with our experts, “National Policy Pulse,” happens every Monday at 3:30 p.m. ET. Register for the calls (registration required even if you were registered for the previous 3:30 p.m. policy update calls) here.

 

OTHER

  • (NEW) Judge Denies Injunction in Work Requirements Suit, Rule Effective July 31. A Massachusetts District Court denied the request of 26 states to halt enforcement of the Medicaid Interim Final Rule on Community Engagement Requirements in their state. In the suit, filed on June 29, the plaintiffs alleged that the IFR went significantly beyond the statute by requiring individuals seeking exclusion through “medical frailty” to demonstrate a connection between their serious or complex medical condition and their inability to meet the work requirement. The suit claims that CMS’ rule did not contemplate the burden on the implementing states, was arbitrary and capricious in their expansion beyond the statute and called for “preliminary relief … to avert irreparable harm” by staying the IFR’s challenged provisions and effective date of July 31 in the plaintiff states. Preliminary relief was denied to the plaintiff states, though the judge indicated upcoming consultation of the parties to conduct full briefing of the arguments prior to the January 1 compliance date for work reporting requirements. The rule is effective July 31, and states will be proceeding accordingly with establishment of policy and IT systems necessary for compliance. Even if the suit proceeds, with a ruling in favor of the plaintiffs, work reporting requirements will remain, though some of the more onerous additions in the rule, such as qualification for an exclusion will be rolled back.

  • (NEW) HHS OCR Settlement Involving Healthcare System Ransomware Attack. The Department of Health and Human Services, Office of Civil Rights (OCR) recently announced that it entered into a settlement agreement with OSF Healthcare System (OSF), concerning potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules. OCR initiated an investigation of OSF after OSF filed a breach report in October 2021 that its files had been infected with the “Nephilim” variant of ransomware. OCR found that OSF had potentially violated provisions of the Privacy, Security and Breach Notification Rules, including by: failing to conduct an accurate and thorough risk analysis of the potential risks and vulnerabilities to the electronic protected health information held by OSF; impermissibly disclosing the protected health information of 53,907 individuals; failing to provide timely breach notification to affected individuals; and failing to provide timely breach notification to the Secretary of HHS. Under the terms of the resolution agreement, OSF agreed to implement a corrective action plan, which includes conducting a risk analysis and developing and implementing a risk management plan, that OCR will monitor for two years and paid $552,250 to OCR.

  • (NEW) Senate Budget Hearing Slams Medicaid Payment Policies and Program Integrity. On August 4, Senator Ron Johnson (R-WI) held his first hearing as the new chair of the Senate Budget Committee, a position he took on after the passing of Senator Lindsay Graham (R-SC). While the Budget Committee does not have jurisdiction over the Medicaid program.  This Committee is in a position to direct cuts to the Medicaid program through a budget reconciliation process, as occurred in 2025 when HR 1 cut federal Medicaid funding to states by about $911 billion over the next 10 years. During the hearing, “Medicaid: The Reality,” the Committee heard testimony from three witnesses: Brian Blase, Paragon Health Institute, Mr. Jonathan Ingram, Foundation for Government Accountability, and Andy Schneider, Center for Children and Families McCourt School of Public Policy at Georgetown University. Mr. Blase and Mr. Ingram both discussed Medicaid’s federal fiscal matching policy, with particular attention to the enhanced federal match for expenses incurred by states for Medicaid expansion enrollees. Both witnesses focused on the need for reforms to shift what they described as current financial “incentives” for states so as to better align Medicaid payment policy with a focus on the ideals and populations Medicaid was originally designed for - older adults, people with disabilities, children, and moms. Mr. Schneider focused on the loss of healthcare coverage as policies from HR 1 are implemented and the impact of rural healthcare provider closures. Chair Johnson urged a fact-based approach to understand what he described as “out of control Medicaid spending growth.” Though remaining moderately civil, the two parties clashed over messaging. Democrats focused on the administration’s firing of Inspectors General and pardoning of convicted fraudsters, while Republicans attacked state credibility in administration of state eligibility categorization and fraud control efforts. Early in the hearing, Senators John Kennedy (R-LA) and Bernie Moreno (R-OH) questioned Mr. Schneider over their assumptions that states improperly drive up Medicaid enrollment through the expansion pathway to cheat the federal government out of funding. The narrative continued as Mr. Blase described Medicaid financing in a way that implied it generates revenues for states through federal matching dollars, instead of the federal government sharing with states in the total cost of eligible services. The full hearing can be watched here.

  • (NEW) CMS Releases Toolkit Signaling Targeted Medicaid HCBS Fraud Focus. On August 4, The Centers for Medicare and Medicaid Services (CMS) released a toolkit for states to support person centered services, safeguard program integrity, and protect individuals from inappropriate treatment. The toolkit is specifically targeted for states for use in their youth autism spectrum disorder programs, though CMS’s approach speaks to a broader undermining of confidence in Medicaid home and community-based services (HCBS). The toolkit’s press release cites rapid utilization growth in Applied Behavioral Analysis (ABA) service provision, relating that the growth “raises important questions about whether Medicaid resources are consistently supporting medically appropriate care. It also signals that rapid program growth requires stronger oversight to ensure children receive services based on medical need rather than financial incentives.” Though there are distinct differences between ABA and other HCBS, the focus and overt mention that the attention is a result of program growth is reflective of the concerning trend in messaging that undermines the credibility and necessity of HCBS in providing life sustaining services. That said, the toolkit could be a useful model for states and may be a model for policy efforts bolstering internal controls for HCBS access, utilization, and provider oversight.

  • (NEW) More Messaging Highlighting Fraud Crackdowns in Medicaid. In a press release relating to a press conference held in Philadelphia on August 4, the Trump Administration touted recent Medicaid home care fraud charges and expansion of a Fraud Taskforce as a whole-of-government approach to fraud detection and prosecution. The National Fraud Enforcement Division expanded the Northeast Health Care Fraud Strike Force to Philadelphia and the surrounding areas to include coordination and collaboration with the Pennsylvania Attorney General and the Department of Justice Eastern District of Pennsylvania. The release and remarks in the press conference referenced the Eastern District of Pennsylvania’s strong track record in healthcare corporate accountability, and connecting this record to a systemic fraud crackdown in Pennsylvania and surrounding geographies. The release goes on to discuss charges against individuals in what appear to be consumer-directed individual arrangements where Medicaid was billed for services that were never rendered.

Remarks at the press conference were delivered by officials representing multiple departments within the administration from the Department of Justice to the Federal Bureau of Investigation. Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz and Deputy Administrator Kim Brandt recounted the efforts of the in rooting out fraud at CMS. Administrator Oz and Ms.Brandt both challenged the program integrity enforcement in Pennsylvania citing high utilization of personal care services and exponential growth in utilization of Applied Behavioral Analysis (ABA), a service available to children with Autism. The CMS team used the opportunity to announce a toolkit for states on ABA. Brandt noted the removal of 1,067 in California alone, representing a 47% reduction in hospices in the state.

The release is available here and the press conference is available here

  • (NEW) CCSQ Announces Next Quarterly Stakeholder Webinar on August 26. On Wednesday, August 26, 11 am – 12 p.m. ET, the Center for Clinical Standards and Quality (CCSQ) will host a webinar led by Dr. Dora Hughes, Chief Medical Officer of CMS and Director of CCSQ on their work to strengthen health care quality, safety, and coverage. Hear the latest on recent policy developments and how these efforts are accelerating progress toward improving care and outcomes for beneficiaries in Medicare, Medicaid, and the Marketplace. Register here for this webinar.

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