New CMS Directive Gives Home Health Providers Greater Visibility Into Denials
CMS now requires Medicare Administrative Contractors to post quarterly Targeted Probe and Educate results, effective November 2, 2026, in a move advocates say could reduce home health claim denials.
Key Facts
- Affected providers
- Home Health
- Effective date
- Nov 1, 2026
Linked deadline
CMS requirement for MACs to publish quarterly TPE results takes effect — Nov 1, 2026
The Centers for Medicare & Medicaid Services now requires Medicare Administrative Contractors (MACs) to post quarterly information on their websites, a change advocates say could reduce home health claim denials.
The move, effective November 2, 2026, aims to better inform providers and suppliers about issues and trends affecting home health, hospice, and other healthcare sectors. CMS will require MACs to post quarterly results from the Targeted Probe and Educate (TPE) program, which is intended to reduce claim denials and appeals.
LeadingAge said the added transparency should improve payment accuracy because providers can see the sources and causes of errors, and that added visibility will help advocates identify differences between MACs. "Overall, we think that this is great first move and look forward to continuing discussions with CMS and its contractors," Mollie Gurian, LeadingAge's vice president of policy and government affairs, told Home Health Care News.
The change follows industry feedback to CMS that quarterly results keep providers informed, according to the agency's September 30 filing, and the requirement aims to ensure publication consistency across Medicare contractors. Contractors must publish the most common denial reasons for each TPE priority area, listing the top three where applicable.
"Requiring Medicare Administrative Contractors to post quarterly TPE results on their websites is a welcome step toward greater transparency," the National Alliance for Care at Home told Home Health Care News.
Sources & References
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