The Centers for Medicare & Medicaid Services (CMS) now requires Medicare Administrative Contractors (MACs) to post quarterly information on their websites, which could reduce home health claim denials.
The move, which will go into effect Nov. 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, intended to reduce claim denials and appeals.
Added transparency will ultimately improve payment accuracy, according to LeadingAge, because providers can see the sources and causes of errors. The added visibility will also help advocates identify differences between MACs, the organization said, allowing them to work with providers when oversight actions appear to be inconsistent with regulations.
“Overall, we think that this is great first move and look forward to continuing discussions with CMS and its contractors and advancing recommendations for other actions that’ll result in more targeted and transparent oversight,” LeadingAge Vice President of Policy and Government Affairs Mollie Gurian told Home Health Care News.
Washington, DC-based LeadingAge is an advocacy organization representing over 5,300 nonprofit aging services organizations, including home-based care providers.
The change follows industry feedback to CMS that quarterly results keep providers informed, according to the agency’s Sept. 30 filing. The requirement aims to ensure publication consistency across Medicare contractors.
“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 (the Alliance) told HHCN.
The Alliance, based in Alexandria, Virginia, is an advocacy organization representing over two million professionals in home health, home care, hospice and other healthcare fields.
Under the new rule, contractors must publish the most common denial reasons for each TPE priority area, listing the top three where applicable. The requirement applies to contractors overseeing home health and hospice claims, among other sectors. Reporting additional denial reasons beyond those three is optional, although CMS encouraged contractors to include them when useful to providers and suppliers.
The update changes contractors’ reporting obligations, not Medicare coverage.
Visibility to common denial reasons helps providers detect and correct errors before they become compliance issues, the Alliance said.
LeadingAge has previously called for greater transparency into claims information. Such visibility would improve payment accuracy since providers better understand where errors occur and why, Gurian previously wrote in a March letter to CMS Administrator Dr. Mehmet Oz.
