CMS: Medicare and Medicaid Programs and the Children's Health Insurance 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 2025 Rates; Quality Programs Requirements; and Other Policy Changes

Federal Register

Aug 28, 2024

Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2025. This rule also makes changes to Medicare graduate medical education (GME) for teaching hospitals and updates payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals. Among other things, this rule also finalizes the proposal of a separate IPPS payment for establishing and maintaining access to essential medicines; finalizes a new mandatory alternative payment model called the Transforming Episode Accountability Model (TEAM), which will test whether financial accountability for selected episode categories reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries; and finalizes the proposal requiring respiratory illness reporting for hospitals and Critical Access Hospitals (CAHs) as a condition of participation following the expiration of the COVID-19 public health emergency requirements. With three exceptions, this final rule is effective October 1, 2024. Instruction 2 (§ 405.1845) is effective January 1, 2025. Instructions 29 and 31 (§ 482.42(e) and § 485.640(d)) are effective November 1, 2024.

Graduate medical education · Healthcare business and finance · Healthcare quality · Hospitals · Inpatient care · Legislation and regulations · Long-term care · Medicare · Pharmacy and prescription drugs · Post-acute care · Reimbursement and payment models · Service delivery models