What Happens When Every Medicare Revocation Becomes Retroactive?
The CY 2027 home health rule deletes the 30-day prospective revocation date at 42 CFR 424.535(g) and makes every remaining ground retroactive to the day your non-compliance began. CMS priced it at $82 million a year coming out of providers, put the number in the same accounting statement as the $415 million going into home health, and cut the post-revocation claims window from 60 days to 15. It applies to every enrolled provider and supplier, not just home health agencies, and it takes effect January 3.
There is one accounting statement in the CY 2027 home health final rule, and it carries two transfers pointing in opposite directions.
The first is the one everybody wrote up: $415 million, "Federal Government To Medicare HHAs."
The second sits four lines below it. Negative $82 million, "Federal Government To Medicare Providers and Suppliers."
Not home health agencies. Providers and suppliers. All of them.
"Non-compliance at any level and to any degree remains non-compliance."
That sentence is CMS answering a comment in section V of CMS-1844-F, which filed for public inspection on November 4 at 5:00 p.m. and publishes Monday.
The rule runs 447 pages and amends eight parts of 42 CFR. The home health rate book is one of them.
Part 424, subpart P, where your enrollment lives, is another.
The Paragraph That Disappears
Today, § 424.535(g)(1) says a revocation takes effect 30 days after CMS or its contractor mails the notice. Paragraphs (g)(2)(i) through (xv) carve out the situations that run retroactive instead, back to "the date on which the provider's non-adherence to Medicare requirements commenced."
This rule restructures § 424.535(g) "to remove current § 424.535(g)(1)," the prospective one, and realigns everything else to match the numerical order of the § 424.535(a) revocation reasons. In CMS's own words, the proposal was "to make the remainder of current prospective revocation grounds retroactive."
The remainder. There is no general prospective effective date left.
CMS worked the example itself. Your billing agency changes address on May 1, you miss the 90-day reporting deadline, and the revocation letter goes out August 15.
The old effective date is September 15, and you keep everything you billed in between.
The new one is July 31, the day after the deadline, and those 45 days of payments become money you were never eligible to receive.
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