Proposed Rule for Medicare Payment and Policy Changes
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This proposed rule aims to revise payment systems for acute care and long-term hospitals, while introducing changes to quality programs. It affects hospitals, especially those involved in Medicare and long-term care, and requires adjustments to reporting measures and payment standards.
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Key Changes
- Revision of payment systems for acute care and long-term care hospitals.
- Introduction of new measures and adjustments to existing quality programs.
- Changes to reporting requirements for electronic clinical quality measures.
Obligations
What this law requires
Submit comments on the proposed rule to CMS by 5 p.m. EDT on April 10, 2026, using one of three methods: electronic submission via https://www.regulations.gov, regular mail to CMS-1849-P P.O. Box 8013 Baltimore MD 21244-8013, or express/overnight mail to CMS-1849-P Mail Stop C4-26-05 7500 Security Boulevard Baltimore MD 21244-1850
Acute care hospitals must comply with revised Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs as updated in this rule
Long-term care hospitals (LTCHs) must comply with updated payment policies and annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services
Teaching hospitals must comply with updated Medicare graduate medical education (GME) payment policies and requirements as specified in the proposed rule
All subject hospitals must update and comply with new requirements for quality programs including Hospital Readmissions Reduction Program, Hospital Acquired Condition Reduction Program, Hospital Inpatient Quality Reporting Program, and Hospital Value-Based Purchasing Program