Hospital at Home Policy Ahead: The Waiver, its Extension and Beyond

Recorded September 11th, 2025

The Hospital at Home Users Group, in partnership with the American Academy of Home Care Medicine, is pleased to present our latest webinar for hospital and system leaders interested in learning about the opportunities and challenges associated with providing acute care in the home.

With the September 30th expiration of the Acute Hospital Care at Home (AHCaH) waiver looming, “What’s Ahead” offers an essential legislative update featuring perspectives of regulators and policy experts.

CMS officials lead off the webinar with an update on the Acute Hospital Care at Home initiative and how it fits with the current administration’s priorities. Complementing this review, a DC policy expert provides an update on the legislative landscape for the AHCaH waiver and discusses opportunities to educate lawmakers on the importance of renewal.

Moderator:

Lisa Tripp, JD
Partner, Tripp Hollander Advisors, LLC

Speakers:

Danielle Adams, MS, BSN, RN
Nurse, Centers for Medicare and Medicaid Services

Ashby Wolfe, MD, MPP, MPH
Regional Chief Medical Officer, Centers for Medicare & Medicaid Services

Meredith Yinger, MPH
Senior Policy Director, Healthsperien, LLC

• There are different implications for HaH programs if there is a government shutdown vs. a waiver lapse.  
  • Shutdown: Programs and Medicare payments continue; CMS personnel may be furloughed but the waiver itself does not end.  
  • Waiver lapse: FFS Medicare and non-managed Medicaid HaH patients must be transitioned out of HaH by Oct 1; programs may continue for MA/commercial patients if state law allows.  
    • In states where HaH authority is tied to the CMS waiver, all programs may need to pause, making it essential for leaders to review state requirements.  
• If the waiver lapses on Sept. 30, several things should be considered. 
  • All FFS Medicare and non-managed Medicaid HaH patients must have documented transition plans before Oct. 1, either back to inpatient units or to discharge.   
  • Programs may continue only where state licensure permits HaH independent of the federal waiver; confirm payer contracts and utilization management pathways.  
  • Hospitals must be prepared to manage logistics and communication with patients and staff, and produce thorough documentation to support clinical and regulatory requirements.  
• The near-term expectation is a continuing resolution (CR) for federal funding. 
  • HaH waiver extensions often ride with funding packages, though Congress could move an extension separately.  
  • CR length will likely shape the waiver duration (short CR → short extension), though a longer HaH extension is also possible.