Health and Human Services Department Final Rule

2026-20067: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction

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Summary

This document corrects technical errors in the final rule that appeared in the August 3, 2026 Federal Register titled "Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements".

The agency’s own summary, as published.

The rule, in full

2,156 words as published, September 30, 2026. View the original →

Federal Register, Volume 91 Issue 188 (Wednesday, September 30, 2026) [Federal Register Volume 91, Number 188 (Wednesday, September 30, 2026)] [Rules and Regulations] [Pages 61791-61795] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 2026-20067] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 418 [CMS-1851-CN] RIN 0938-AV78 Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction

Agency

Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS).

Action

Final rule; correction. -----------------------------------------------------------------------

Summary

This document corrects technical errors in the final rule that appeared in the August 3, 2026 Federal Register titled ``Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements''.

Dates

This correction is effective October 1, 2026.

For Further Information Contact

For questions regarding the hospice wage index, contact Chantelle Caldwell, (410) 786-8743. For general questions about hospice payment policy, send your inquiry via email to: [email protected].

Supplementary Information

I. Background

In FR Doc. 2026-15686 of August 3, 2026 (91 FR 49118), there were a number of technical errors that are identified and corrected in this correcting document. The provisions in this correction document are effective as [[Page 61792]] if they had been included in the final rule that appeared in the August 3, 2026 Federal Register. Accordingly, the corrections are effective October 1, 2026.

A. Summary of Errors in the Preamble

As discussed in the fiscal year (FY) 2027 hospice final rule (91 FR 49122 through 49123), in developing the hospice wage index, we used the FY 2027 Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) pre-floor, pre-reclassified wage index for hospital cost reporting periods beginning on or after October 1, 2022 and before October 1, 2023 (FY 2023 cost report data). We made an inadvertent technical error when calculating the FY 2027 pre-floor, pre-reclassified IPPS wage index. Under our methodologies as finalized in the FY 2027 IPPS/Long Term Care Hospitals (LTCH) PPS final rule, we exclude rural emergency hospitals (REHs), including hospitals that subsequently became REHs after the period from which the data were taken, from certain data and calculations used in the IPPS rate setting, including the development of the Medicare Severity Diagnosis- Related Group (MS-DRG) relative weights for FY 2027 (91 FR 49672) and the calculation of the standardized amount (91 FR 50370). In addition, we stated that any hospital that is designated as an REH by 7 days prior to the publication of the preliminary wage index public use file is excluded from the calculation of the wage index (91 FR 49791). We inadvertently treated a current IPPS hospital (CMS Certification Number 250078) as a hospital that had converted to REH status, thereby erroneously excluding its data from the MS-DRG relative weight calculation and the wage index. Therefore, we restored the applicable data for this hospital and recalculated the FY 2027 IPPS pre-floor, pre-reclassified hospital wage index. As the result of this technical error that affected the FY 2027 IPPS pre-floor, pre-reclassified wage index, we have recalculated the FY 2027 hospice wage index values for all Core-Based Statistical Areas (CBSAs) and rural areas, the wage index standardization factors and subsequently the national payment rates for each level of hospice care as well as our impact analysis. Therefore, we made conforming changes to the following: On page 49122, the wage index values listed for CBSA 25980, Hinesville, Georgia and rural North Dakota. On page 49127, Tables 1 and 2 titled ``Final FY 2027 Hospice RHC Payment Rates'' and ``Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates''. On page 49128, Tables 3 and 4 titled ``Final FY 2027 Hospice RHC Payment Rates for Hospices That DO NOT Submit the Required Quality Data'' and ``Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates for Hospices That DO NOT Submit the Required Quality Data''. On page 49170, Table 22 titled ``Impact to Hospices for FY 2027''. On page 49175, the impact percentage for hospices with greater than 20,000 RHC days.

B. Summary of Errors and Corrections Posted on the CMS website

As discussed in section II.A. of this document, a hospital was inadvertently omitted from the FY 2027 IPPS pre-floor, pre-reclassified hospital wage index which necessitated the recalculation of the FY 2027 hospice wage index. That error was subsequently included in the FY 2027 Hospice Wage Index file exclusively on the CMS website. Given the error, we have recalculated the FY 2027 final hospice wage index and are republishing the FY 2027 Hospice Wage Index file accordingly on the CMS website at https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-wage-index and https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-regulations-and-notices/cms-1851-f.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

Section 1871(b)(1) of the Social Security Act (the Act) requires the Secretary to provide for notice of a proposed rule in the Federal Register and provide a period of not less than 60 days for public comment. In addition, section 1871(e)(1)(B)(i) of the Act mandates a 30-day delay in effective date after issuance or publication of a rule. Section 1871(b)(2)(C) of the Act provides an exception from the notice and 60-day comment period and delay in effective date requirements of the Act, under the good cause standard set forth in 5 U.S.C. 553(b)(B). Section 1871(e)(1)(B)(ii) of the Act provides an exception from the delay in effective date requirements of the Act as well. Section 553(b)(B) authorizes an agency to dispense with normal notice and comment rulemaking procedures for good cause if the agency makes a finding that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and includes a statement of the finding and the reasons for it in the rule. In addition, section 1871(e)(1)(B)(ii) of the Act allows the agency to avoid the 30-day delay in effective date where the waiver is necessary to comply with statutory requirements or such delay is contrary to the public interest and the agency includes in the rule a statement of the finding and the reasons for it. In our view, this correcting document does not constitute a rulemaking that would be subject to these requirements. This document merely corrects technical errors in the FY 2027 hospice wage index that required updates to the preamble, payment rates, and tables included or referenced in the FY 2027 Hospice final rule. The corrections contained in this document are consistent with, and do not make substantive changes to, the policies and payment methodologies that were proposed, subject to notice and comment procedures, and adopted in the FY 2027 Hospice final rule. As a result, the corrections made through this document are intended to resolve inadvertent errors so that the FY 2027 Hospice final rule accurately reflects the policies adopted therein. In addition, even if this were a rule to which the notice and comment procedures and delayed effective date requirements applied, we find that there is good cause to waive such requirements. Undertaking further notice and comment procedures to incorporate the corrections in this document into the final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2027 Hospice final rule accurately reflects our policies. Furthermore, such procedures would be unnecessary, as we are not altering our payment methodologies or policies, but rather, we are simply implementing correctly the methodologies and policies that we previously proposed, requested comment on, and subsequently finalized. This final rule correction is intended solely to ensure that the FY 2027 Hospice final rule accurately reflects these payment methodologies and policies. Therefore, we believe we have good cause to waive the notice and comment and effective date requirements.

IV. Correction of Errors

In FR Doc. 2026-15686 of August 3, 2026 (91 FR 49118), make the following corrections:

1. On page 49122,

[[Page 61793]] a. Second column, second full paragraph, last line, the figure ``0.8915'' is corrected to read ``0.8916''. b. Third column, first partial paragraph, last line, the figure ``0.8297'' is corrected to read ``0.8298''.

2. On page 49127, middle of the page,

a. Table 1 titled ``Final FY 2027 Hospice RHC Payment Rates'' is corrected to read as follows: Table 1--Final FY 2027 Hospice RHC Payment Rates ---------------------------------------------------------------------------------------------------------------- SIA budget Wage index FY 2027 Code Description FY 2026 neutrality standardization hospice FY 2027 payment rates factor factor payment update payment rates ---------------------------------------------------------------------------------------------------------------- 651....... Routine Home Care $230.83 0.9999 1.0009 1.023 $236.33 (days 1-60). 651....... Routine Home Care 181.94 0.9999 1.0012 1.023 186.33 (days 61+). ---------------------------------------------------------------------------------------------------------------- b. Table 2 titled ``Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates'' is corrected to read as follows: Table 2--Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates ---------------------------------------------------------------------------------------------------------------- FY 2027 FY 2026 Wage index hospice Code Description payment rates standardization payment FY 2027 payment rates factor update ---------------------------------------------------------------------------------------------------------------- 652............ Continuous Home Care $1,674.29 1.0078 1.023 $1,726.16 ($71.92 per Full Rate = 24 hours hour). of care. 655............ Inpatient Respite 532.48 1.0022 1.023 $545.93. Care. 656............ General Inpatient 1,199.86 1.0033 1.023 $1,231.51. Care. ----------------------------------------------------------------------------------------------------------------

3. On page 49128, middle of the page,

a. Table 3 titled ``Final FY 2027 Hospice RHC Payment Rates for Hospices That DO NOT Submit the Required Quality Data'' is corrected to read as follows: Table 3--Final FY 2027 Hospice RHC Payment Rates for Hospices That DO NOT Submit the Required Quality Data ---------------------------------------------------------------------------------------------------------------- FY 2027 hospice SIA Budget Wage Index payment update of Code Description FY 2026 Neutrality Standardization 2.3% -4 Payment Rates Factor Factor percentage points = -1.7% ---------------------------------------------------------------------------------------------------------------- 651...... Routine Home $230.83 0.9999 1.0009 0.983 $227.09 Care (days 1- 60). 651...... Routine Home 181.94 0.9999 1.0012 0.983 179.04 Care (days 61+). ---------------------------------------------------------------------------------------------------------------- b. Table 4 titled ``Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates for Hospices That DO NOT Submit the Required Quality Data'' is corrected to read as follows: Table 4--Final FY 2027 Hospice, CHC, IRC, and GIP Payment Rates for Hospices That DO NOT Submit the Required Quality Data ---------------------------------------------------------------------------------------------------------------- FY 2027 hospice Wage Index payment update of Code Description FY 2026 Standardization 2.3% -4 FY 2027 payment Payment Rates factor percentage points rates = -1.7% ---------------------------------------------------------------------------------------------------------------- 652........... Continuous Home Care $1,674.29 1.0078 0.983 $1,658.66 ($69.11 Full Rate = 24 per hour). hours of care. 655........... Inpatient Respite 532.48 1.0022 0.983 524.58 Care. 656........... General Inpatient 1,199.86 1.0033 0.983 1,183.35 Care. ---------------------------------------------------------------------------------------------------------------- [[Page 61794]]

4. On page 49170, Table 22 titled ``Impact to Hospices for FY

2027'' is corrected to read as follows: Table 22--Impact to Hospices for FY 2027 ---------------------------------------------------------------------------------------------------------------- FY 2027 hospice Overall Total Hospice subgroup Hospices FY 2027 updated payment update Impact for FY wage data (%) (%) 2027 (%) ---------------------------------------------------------------------------------------------------------------- All Hospices........................ 6,673 0.0 2.3 2.3 Hospice Type and Control: Freestanding/Non-Profit......... 782 0.0 2.3 2.3 Freestanding/For-Profit......... 4,856 0.0 2.3 2.3 Freestanding/Government......... 34 0.6 2.3 2.9 Freestanding/Other.............. 0 0.0 2.3 2.3 Facility/HHA Based/Non-Profit... 258 0.0 2.3 2.3 Facility/HHA Based/For-Profit... 3 1.2 2.3 3.5 Facility/HHA Based/Government... 94 1.0 2.3 3.3 Facility/HHA Based/Other........ 0 0.0 2.3 2.3 --------------------------------------------------------------------------- Subtotal: Freestanding 5,672 0.0 2.3 2.3 Facility Type.............. --------------------------------------------------------------------------- Subtotal: Facility/HHA Based 355 0.2 2.3 2.5 Facility Type.............. --------------------------------------------------------------------------- Subtotal: Non-Profit.... 1,050 0.0 2.3 2.3 --------------------------------------------------------------------------- Subtotal: For Profit.... 5,172 0.0 2.3 2.3 --------------------------------------------------------------------------- Subtotal: Government.... 128 0.9 2.3 3.2 --------------------------------------------------------------------------- Subtotal: Other......... 6 0.7 2.3 3.0 --------------------------------------------------------------------------- Hospice Type and Control: Rural: Freestanding/Non-Profit......... 203 0.9 2.3 3.2 Freestanding/For-Profit......... 408 0.4 2.3 2.7 Freestanding/Government......... 22 0.6 2.3 2.9 Freestanding/Other.............. 0 0.0 2.3 2.3 Facility/HHA Based/Non-Profit... 108 0.7 2.3 3.0 Facility/HHA Based/For-Profit... 0 0.0 2.3 2.3 Facility/HHA Based/Government... 68 1.1 2.3 3.4 Facility/HHA Based/Other........ 0 0.0 2.3 2.3 Hospice Type and Control: Urban: Freestanding/Non-Profit......... 579 -0.1 2.3 2.2 Freestanding/For-Profit......... 4,448 -0.1 2.3 2.2 Freestanding/Government......... 12 0.7 2.3 3.0 Freestanding/Other.............. 0 0.0 2.3 2.3 Facility/HHA Based/Non-Profit... 150 -0.1 2.3 2.2 Facility/HHA Based/For-Profit... 3 1.2 2.3 3.5 Facility/HHA Based/Government... 26 1.0 2.3 3.3 Facility/HHA Based/Other........ 0 0.0 2.3 2.3 Hospice Location: Urban or Rural: Rural........................... 857 0.6 2.3 2.9 Urban........................... 5,816 -0.1 2.3 2.2 Hospice Location: Region of the Country (Census Division): New England..................... 162 0.8 2.3 3.1 Middle Atlantic................. 282 0.6 2.3 2.9 South Atlantic.................. 653 -0.1 2.3 2.2 East North Central.............. 661 -0.2 2.3 2.1 East South Central.............. 252 -0.3 2.3 2.0 West North Central.............. 446 0.4 2.3 2.7 West South Central.............. 1,302 -0.4 2.3 1.9 Mountain........................ 697 -0.2 2.3 2.1 Pacific......................... 2,137 0.2 2.3 2.5 Outlying........................ 81 1.1 2.3 3.4 Hospice Size: 0-3,499 RHC Days (Small)........ 1,611 0.2 2.3 2.5 3,500-19,999 RHC Days (Medium).. 2,984 0.2 2.3 2.5 20,000+ RHC Days (Large)........ 2,078 -0.1 2.3 2.2 ---------------------------------------------------------------------------------------------------------------- [[Page 61795]]

5. On page 49175, first column, first paragraph, line 17, the

figure ``2.3 percent'' is corrected to read ``2.2 percent''. Liesl I. Fowler, Executive Secretary to the Department, Department of Health and Human Services. [FR Doc. 2026-20067 Filed 9-29-26; 8:45 am] BILLING CODE 4169-69-P

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Amends 1 part of the Code of Federal Regulations — the standing rules this notice rewrites.

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