Volume 25.04
On Friday, April 11, 2025, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released numerous proposed rules encompassing multiple types of providers.
Fiscal year 2026 Hospice Wage Index and Payment Update – On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Update Proposed Rule (CMS-1835-P).
For FY 2026, CMS proposes to update the hospice payment rate by 2.4%. This results from the proposed 3.2% inpatient hospital market basket percentage increase reduced by a proposed 0.8 percentage point productivity adjustment, required by law. The proposed FY 2026 rates for hospices that do not submit the required quality data would reflect the proposed FY 2026 hospice payment update percentage of 2.4% minus four percentage points as required by law, which would result in a 1.6% reduction over the previous year’s payment rate.
Federal Register :: Public Inspection: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
Fiscal Year 2026 Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule – On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for inpatient rehabilitation facilities under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for fiscal year (FY) 2026.
For FY 2026, CMS proposes to update the IRF PPS payment rates by 2.6% based on the proposed IRF market basket update of 3.4%, less a proposed 0.8 percentage point productivity adjustment. The proposed rule includes annual updates to the prospective payment rates, the outlier threshold, the case-mix-group relative weights and average length of stay values, the wage index, and associated impact analysis.
Federal Register :: Public Inspection: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the Inpatient Rehabilitation Facility Quality Reporting Program
Fiscal Year 2026 Medicare Inpatient Psychiatric Facility Prospective Payment System and Quality Report Updates Proposed Rule – On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for Inpatient Psychiatric Facilities, under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) and Quality Reporting (IPFQR) Updates Proposed Rule (CMS-1831-P), for fiscal year (FY) 2026.
For FY 2026, CMS is proposing to update the IPF PPS payment rates by 2.4%, based on the proposed 2021-based IPF market basket increase of 3.2% less a proposed 0.8 percentage point productivity adjustment.
Federal Register :: Public Inspection: Medicare Program: Fiscal Year 2026 Inpatient Psychiatric Facilities Prospective Payment System – Rate Update
Fiscal Year 2026 Skilled Nursing Facility Prospective Payment System Proposed Rule – On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2026.
For FY 2026, CMS proposes updating SNF PPS rates by 2.8% based on the proposed SNF market basket of 3.0%, plus a 0.6% market basket forecast error adjustment, and a negative 0.8% productivity adjustment.
Federal Register :: Public Inspection: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospitals Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates – On April 11, 2025, CMS released the proposed rule which would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); update and make changes to requirements for certain quality programs; and make other policy-related changes.
Federal Register :: Public Inspection: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates