Rule2026-20067
Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction
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Published
September 30, 2026
Effective
October 1, 2026
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
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".
Full Text
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<title>Federal Register, Volume 91 Issue 188 (Wednesday, September 30, 2026)</title>
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[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 [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-20067]
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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.
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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''.
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:
<a href="/cdn-cgi/l/email-protection#8ee6e1fdfee7edebfee1e2e7edf7ceede3fda0e6e6fda0e9e1f8"><span class="__cf_email__" data-cfemail="4b2324383b22282e3b24272228320b28263865232338652c243d">[email protected]</span></a>.
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.
II. Summary of Errors
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 <a href="https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-wage-index">https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-wage-index</a> and <a href="https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-regulations-and-notices/cms-1851-f">https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-regulations-and-notices/cms-1851-f</a>.
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
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SIA budget Wage index FY 2027
Code Description FY 2026 neutrality standardization hospice FY 2027
payment rates factor factor payment update payment rates
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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+).
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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
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FY 2027
FY 2026 Wage index hospice
Code Description payment rates standardization payment FY 2027 payment rates
factor update
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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.
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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+).
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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%
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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.
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[[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
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FY 2027 hospice Overall Total
Hospice subgroup Hospices FY 2027 updated payment update Impact for FY
wage data (%) (%) 2027 (%)
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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
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Subtotal: Freestanding 5,672 0.0 2.3 2.3
Facility Type..............
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Subtotal: Facility/HHA Based 355 0.2 2.3 2.5
Facility Type..............
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Subtotal: Non-Profit.... 1,050 0.0 2.3 2.3
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Subtotal: For Profit.... 5,172 0.0 2.3 2.3
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Subtotal: Government.... 128 0.9 2.3 3.2
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Subtotal: Other......... 6 0.7 2.3 3.0
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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
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[[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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