Congress has passed, and the President has signed, the Consolidated Appropriations Act, 2026, bringing an end to the brief federal government shutdown and restoring funding for most federal agencies through September 30, 2026. In addition to reopening the government, the legislation includes several provisions of direct relevance to home health, hospice, and hospital-at-home providers.

The Act extends key Medicare telehealth flexibilities that originated during the COVID-19 public health emergency through December 31, 2027. These extensions preserve the removal of geographic restrictions and allow the patient’s home to continue to serve as an eligible originating site for telehealth services.

For home health agencies, this means that telehealth (audio and video) may continue to be used to satisfy the face-to-face encounter requirement for Medicare and Medicaid eligibility during this period.

For hospice providers, telehealth may also continue to be used to conduct face-to-face encounters through December 31, 2027, with limitations. The telehealth flexibility does not apply if:

• The hospice is located in an area subject to a CMS enrollment moratorium, or
• The hospice provider is under the Provisional Period of Enhanced Oversight (PPEO).

In addition, the Act directs the Secretary of Health and Human Services to require the use of one or more claim modifiers to indicate when a hospice face-to-face encounter was conducted via telehealth. This modifier requirement applies to encounters occurring on or after January 1, 2027. Additional operational guidance is expected from Medicare Administrative Contractors (MACs). 

The legislation also extends the Medicare Acute Hospital Care at Home waiver for five years, through September 30, 2030. This longer-term extension replaces a series of short-term renewals and provides greater program stability for health systems that have invested in hospital-at-home models. 

The waiver allows eligible hospitals, with approval from Centers for Medicare & Medicaid Services, to furnish inpatient-level hospital services in a patient’s home when specified conditions are met.

In addition, the Act includes provisions intended to streamline Medicaid enrollment for providers furnishing services to individuals under age 21 in a state other than their primary Medicaid enrollment state. Further implementation guidance from states and CMS is expected.