ASE Submits Comments on the CY 2027 Home Health Prospective Payment System Proposed Rule

On August 24, ASE submitted comments to CMS Administrator Mehmet Oz on the Medicare provider-enrollment provisions of the proposed CY 2027 Home Health Prospective Payment System rule (CMS-1844-P). The letter supports CMS’s goal of protecting Medicare from fraud, waste, and abuse, but raises concerns about several provisions: a proposal to make revocations retroactive by default rather than prospective, new denial and revocation authority tied to changes in majority ownership, provisions allowing denial based on an owner’s or “managing employee’s” history with other federal or state programs, and a vague expansion of denial authority to “any other form of business or financial relationship.” For each, ASE recommends narrower, better-defined standards, individualized risk determinations, clear notice, and meaningful opportunities for providers to respond before facing financial or enrollment consequences.

These provisions carry real risk for echocardiography practices and the clinicians who lead them. Retroactive revocations and broadly defined “managing employee” or “business relationship” categories could expose echo labs and the physicians who serve as medical directors or clinical leaders to recoupment or enrollment action over technical issues unrelated to actual ownership or control, potentially disrupting practices’ ability to bill for or furnish diagnostic services. ASE’s recommendations aim to preserve CMS’s ability to police genuine bad actors while protecting compliant echocardiography practices, and the beneficiaries who depend on them, from disproportionate and disruptive consequences.