What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and long-term care hospitals (LTCHs) for federal fiscal year (FFY) 2026.
What else to know: Comments on the proposed rules are due to CMS by June 10.
Key IRF proposals include:
- Updates to payment rates of a net 2.8%, including a 0.2% increase related to outlier payments as well as a proposed market basket update of 3.4%, minus a productivity cut of 0.8 percentage point
- Under the IRF quality reporting program (QRP), removal of four patient assessment data elements and the COVID-19 vaccination measures for both patients and health care personnel
Key SNF proposals include:
- Increases in aggregate SNF payments of an estimated 2.8% ($997 billion) in FFY 2026 compared to FFY 2025
- Technical changes to its Patient-Driven Payment Model International Classification of Diseases, Tenth Revision (ICD-10) code mapping that assigns patients to clinical categories
- In the SNF QRP, removal of four patient assessment data elements
- Removal of the program’s health equity adjustment in the SNF value-based purchasing program
Key LTCH proposals include:
- Increases in net LTCH payments of 2.5% ($61 million) in FFY 2026 compared to FFY 2025, including both standard rate payments ($52 million) and site-neutral payments ($9 million)
- An increase to the standard rate fixed-loss amount for high-cost outlier cases from $77,048 in FFY 2025 to to $91,247 for FFY 2026
- In the LTCH QRP, removal of four patient assessment data elements and modification of the COVID-19 vaccine among patients and residents measure
Comments on the IRF, SNF and LTCH proposed rules can be submitted online. CHA will issue detailed summaries in the coming weeks.
Visit CHA’s Federal Regulatory Tracker to follow new and anticipated federal rules.
