Skip to content

Medicare Payment Rule Advocacy Center


The Centers for Medicare & Medicaid Services (CMS) finalized a permanent 7.85% cut to Medicare home health services in the 2023 Home Health Prospective Payment System (HH PPS) Final Rule. In the final rule, CMS acknowledged the significant cut would create “hardship” for providers, so the agency is phasing in half of the reduction — 3.925% — for Calendar Year (CY) 2023. The one-year phase-in, however, does nothing to mitigate the long-term impact of permanently cutting Medicare home health by 7.85%, or to address the significant flaws in CMS’ approach. While the cut in 2023 is halved, CMS states it will recoup the balance of the 7.85% cut in a future year along with other significant temporary payment reductions. Still, the 2023 cut alone is $635 million on an already shrinking benefit that serves 3.2 million Medicare beneficiaries annually.

  • The 7.85% permanent cut equates to more than $1 billion in cuts annually starting in 2024 and continuing in perpetuity. This will result in devastating, long-term repercussions for home health patients and their providers.
  • These cuts will total more than $18 billion over the next 10 years — even more than what CMS originally proposed in its proposed rule.
  • CMS finalized calculations for additional “clawback cuts” of more than $2 billion for services provided to patients during the COVID-19 pandemic. On top of that $2 billion-plus cut, an additional estimated $1.5 billion will be clawed back from home health providers for services delivered in 2022 and 2023 cut (as a result of CMS phasing in the cut).
  • More than half of Medicare-certified home health agencies will be operating under negative margins as a result of these cuts.
  • CMS finalized these cuts despite strong opposition from patients, providers, and lawmakers.
  • For two rulemaking cycles now, CMS has refused to alter its approach to calculating budget neutrality under the 2018 Bipartisan Budget Act, and instead, it has continued with a methodology that inflicts
    significant disruption and uncertainty into the vital home health benefit.
  • CMS ignored data and recommendations from home health leaders warning about the agency’s methodology for justifying these cuts is deeply flawed and in violation of CMS’ statutory authority.

America’s home health community supports the Preserving Access to Home Health Act (S.4605/H.R.8581). This bipartisan, bicameral legislation prevents these massive cuts from taking effect in the Medicare home health program until 2026. The legislation provides time for CMS to work with the home health sector to re-evaluate and fix CMS’ flawed methodology in calculating Medicare rates.

We urge you to contact your members of Congress and encourage them to cosponsor this legislation!

Through the Medicare Payment Rule Advocacy Center, you can engage your lawmakers in the following ways:

  • Send an email to lawmakers with just a few clicks
  • Setup a meeting with lawmakers in their local offices
  • Call your lawmakers' staff on Capitol Hill about your concerns
  • Make your voice heard by attending a local event with your lawmakers
  • Communicate with lawmakers on social media
  • Write a letter to your local newspaper to raise public awareness

We need the entire home health community involved in fighting for the survival of home health agencies and the continued access to care for the millions of Americans who deserve and depend upon quality care in the home.

Below you will find talking points, fact sheets, and action steps. If you have any questions or need assistance with your advocacy efforts, please contact Kyle Simon, Director of Government Affairs and Communications, at or call (850) 222-8967.

6 Ways to Take Action

Send an Email

Send an email to your members of Congress with just a few clicks

Schedule a Meeting

Coordinate a local meeting with your members of Congress

Call Congress

Call members of Congress in Washington and share your views

Attend an Event

Find and attend a local event with your members of Congress

Spread the Word

Reach out to Congress and drive engagement on social media

Contact the Media

Raise public awareness by writing a letter to your local newspaper

Schedule a Meeting

While Congress is at work in Washington, you can still meet with their staff in their local office. Look up your members of Congress on the Legislative Action Center and call the office that's closest to you. To guide you through the process of requesting a meeting, we've provided a sample script below.

Hi, my name is [NAME] and I’m your constituent calling from [CITY (ZIP code might be requested)].

I am calling to set up a meeting to discuss Medicare home health policy issues, specifically recently introduced legislation that I am hoping [HE/SHE] will support.

Is a representative of Senator/Representative [LAST NAME'S] office able to meet in [HIS/HER] district office or perhaps join me on a Medicare home health visit with a constituent who is receiving services?

[If the staff person asks for additional information, provide a short summary of the issue and provide the bill number.]

Thank you for coordinating the meeting. I look forward to talking with [STAFF PERSON'S NAME] on [DATE/TIME] at [LOCATION].

During the meeting, reference the talking points (above) in your discussion and request support and cosponsorship of the bill. Bring 2-3 copies of fact sheets (above) that provide additional information that you can leave behind as well. After the meeting, send a thank you email reiterating your "ask" and provide any follow-up information requested. HCAF would appreciate hearing from you about your meeting and where your lawmaker stands.

If you need assistance at any point along the way, please contact Kyle Simon, Director of Government Affairs and Communications, at or (850) 222-8967.

Call Congress

When calling your members of Congress, please call their Washington office rather than their district office. The first question you're likely to be asked is "Where do you live?" to determine if you are a constituent.

It is unlikely you will be able to speak directly with your Senators or Representative, so ask to speak with a staff member who handles health care policy. If he/she is not available, please ask to leave your comments with the person who fielded your call.

Congressional staff works long hours — 10 to 12 days are not uncommon — and have many demands and pressures on their time. You should craft a concise and compelling message before you call that:

  • Requests that your Senator/Representative cosponsor S.4605 (Senate bill) or H.R.8581 (House bill), the Preserving Access to Home Health Act
  • Illustrates how the proposed cuts would adversely affect your business and access to care.

Visit the Legislative Action Center and enter your address to identify your lawmakers, then click on the telephone icon for D.C. phone numbers and instructions. HCAF staff would appreciate it if you would complete the post-call survey to let us know how it went.

Attend a Local Event

The reason why Congress takes numerous breaks from their legislative work is so elected officials can get back to their districts and spend time with their constituents. With it being an election year, they are likely to host public events, including town halls. (Well, they are supposed to. Some are better than others at making themselves available.) Attending these town halls is one of the most effective ways to have your voice heard and influence your lawmakers.

To find a town hall or other events for your members of Congress, visit Town Hall Project. If you don’t see one listed, call their district office directly and ask when their next public event will take place.

If you have an opportunity to speak or ask a question of your lawmakers, reference the talking points (above) and request support and cosponsorship of the bill. Bring 2-3 copies of fact sheets (above) that provide additional information that you can leave behind as well. HCAF staff would appreciate hearing from you about your meeting and where your lawmaker stands.

Spread the Word on Social Media

Did you know that 100% of Congress is on social media? In fact, a Congressional Management Foundation poll found that three-quarters of senior congressional staff said that between one and 30 comments on social media platforms like Facebook and Twitter were enough to grab their attention on an issue; 35% said that fewer than 10 comments were enough.

Activate your personal network and connect with your members of Congress to gain their support for the Preserving Access to Home Health Act! Including photos or graphics will make your content stand out and likely drive more engagement with your post, which amplifies your voice and multiplies your impact.

Below are the social media handles for Florida's Senators. You can find your Representative's handles by entering your address on the Legislative Action Center, then visiting their website. Click here for the Florida congressional delegation directory.

Please post the message and graphic below on your social media and tag your lawmakers. (The hashtag "#flapol" refers to, an influential Florida politics site.)

[@HANDLE], please cosponsor the Preserving Access to Home Health Act of 2022 (S.4605/H.R.8581) to prevent #Medicare cuts to #homehealth payment rates and protect access to care for millions of Americans #flapol

Write a Letter to the Editor

Letters to the editor are great advocacy tools to raise public awareness about an issue. After you contact your members of Congress, submitting a letter to the editor of your local newspaper can achieve other advocacy goals because they:

  • Reach a large audience.
  • Are often monitored by elected officials.
  • Can bring up information not addressed in a news article.
  • Create an impression of widespread support for or opposition to an issue.

Provide your thoughts on the issue and describe how it impacts Florida's access to Medicare home health care services.

Click here for tips on writing an effective letter to the editor.