What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) issued its federal fiscal year (FFY) 2026 inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule.
What else to know: Comments on the proposed rule are due to CMS by June 10.
Key proposals include:
- Payment rates were updated by 2.4%, based on the proposed 2021-based IPF market basket increase of 3.2%, minus a proposed 0.8 percentage point productivity adjustment. In addition, the rule proposes to update the outlier threshold so that estimated outlier payments remain at 2% of total payments. Total estimated payments to IPFs would increase by 2.4% ($70 million) in FFY 2026 compared to FFY 2025.
- Adjustment factors for facility teaching status and rural location were updated.
- IPF teaching caps for resident full-time equivalents awarded under Section 4122 of the Consolidated Appropriations Act of 2023 were increased.
- Three health equity measures were removed from the IPF quality reporting program (QRP), as was the COVID-19 vaccination for health care personnel measure. The reporting period of one measure was also modified.
- The Extraordinary Circumstances Exception policy was updated, and the process for requesting or granting an exception was codified.
- Requests for information on future changes to the IPF QRP — including future star ratings for IPFs, measure concepts on well-being and nutrition, and digital quality measurement — were issued.
Additional details are available in a CMS fact sheet. CHA will issue a detailed summary in the future.
Visit CHA’s Federal Regulatory Tracker to follow new and anticipated federal rules.
