Your Voice Matters: Why Commenting on CMS Proposed Rules is One of the Most Powerful Advocacy Tools You Have

by Jamie Daugherty, Executive Director

Every year, the Centers for Medicare & Medicaid Services (CMS) publishes proposed rules that determine how home health, hospice, home care, and other healthcare providers will operate for years to come. Payment rates, quality measures, documentation requirements, value-based purchasing, staffing expectations, and compliance requirements all begin as proposals—not final policy. 

Yet despite the enormous impact these rules have on providers and patients alike, relatively few frontline clinicians, agency leaders, and owners ever submit comments.

That represents a missed opportunity.

At the Oregon Association for Home Care, advocacy isn't limited to legislative sessions or meetings with elected officials. One of the most effective ways to influence federal policy is through the public comment process.

Why CMS Requests Comments

Federal agencies are required to seek public input before implementing significant regulations. The proposed rule is exactly what it sounds like—a proposal.

CMS wants to hear from:

  • Providers
  • Patients and caregivers
  • Industry organizations
  • Researchers
  • State agencies
  • Professional associations

Every substantive comment becomes part of the official public record.

While not every recommendation is adopted, CMS regularly modifies proposals after reviewing stakeholder feedback. Well-supported comments absolutely can influence the final rule. 

Why Individual Provider Comments Matter

National associations—including the National Alliance for Care at Home—submit comprehensive comment letters representing thousands of providers.

State associations like OAHC also advocate on behalf of Oregon providers.

But CMS values hearing directly from agencies delivering care every day. 

Your experience provides evidence that data alone cannot.

For example:

  • How a documentation requirement affects clinician productivity
  • Challenges unique to serving rural communities
  • Workforce shortages that make proposed requirements difficult to implement
  • Administrative burdens that divert time from patient care
  • Real-world patient access issues

Those stories help policymakers understand the practical consequences of regulation.

Effective Comments Are Specific

The most persuasive comments are not emotional—they're factual.

Instead of saying:

"This rule is terrible."

Consider saying:

"Our agency serves six frontier counties. The proposed documentation requirement would require approximately three additional hours per clinician each week, reducing our ability to admit new Medicare beneficiaries."

Even stronger comments include:

  • Actual staffing data
  • Operational examples
  • Financial impact
  • Patient outcomes
  • Rural challenges
  • Suggested alternatives

CMS is much more likely to consider comments that explain both the problem and a workable solution.

Quantity Matters Too

One thoughtful comment is valuable.

One hundred thoughtful comments from providers across Oregon send an even stronger message. 

When policymakers see similar concerns repeated across multiple agencies, regions, and provider types, those issues receive greater attention.

This is especially important for rural states like Oregon, where provider availability, geography, and workforce shortages create challenges that aren't always reflected in national data.

Don't Wait Until the Last Minute

CMS comment periods generally last 60 days.

Unfortunately, many organizations wait until the final week before reviewing lengthy proposed rules.

Instead:

  • Review summaries early.
  • Identify sections that affect your agency.
  • Coordinate with your leadership team.
  • Work with your state association.
  • Submit comments before the deadline.

Early preparation also allows organizations to gather operational data that strengthens their recommendations.

OAHC Is Here to Help

One of OAHC's priorities is helping members understand proposed federal regulations and identify the issues most relevant to Oregon providers.

Throughout the year, we'll continue providing:

  • Rule summaries
  • Educational webinars
  • Regulatory updates
  • Sample talking points
  • Advocacy opportunities
  • Resources to support meaningful public comments

Our goal isn't simply to explain new regulations after they're finalized—it's to help shape them before they become policy.

Advocacy Doesn't End When a Bill Passes

Many providers think of advocacy as contacting legislators or attending the Capitol.

Those activities matter, but so does participating in the regulatory process.

Every CMS proposed rule represents an opportunity for providers to share their expertise, improve future policy, and ultimately protect patient access to care.

The people writing these regulations need to hear from the professionals who implement them every day.

Your experience matters.

Your patients matter.

And your voice can help shape the future of home-based care.

Call to Action

As new CMS proposed rules are released, OAHC will provide summaries, educational resources, and opportunities for members to engage in the federal rulemaking process. Watch your email and visit our website for upcoming advocacy alerts and regulatory guidance. Together, we can ensure Oregon's providers—and the patients they serve—are represented in the policies that shape our profession.