About Medicare

The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.

Medicare Inpatient Rule: Mandatory Bundled Payment Model

The Centers for Medicare and Medicaid Services (CMS) proposed the Transforming Episode Accountability Model (TEAM), which will hold selected hospitals accountable for the cost and quality of certain surgical procedures. TEAM aims to improve outcomes for Medicare patients undergoing certain high-volume surgical procedures while reducing Medicare spending.

CMS Proposes Inadequate Inpatient Payment Update

What’s happening: The Centers for Medicare & Medicaid Services’ (CMS) proposed fiscal year (FY) 2025 inpatient prospective payment system (IPPS) rule falls short of what hospitals need to keep up with rising costs and health care needs.  

What else to know: The rule includes a net market basket update of 2.6%. As a result of all proposed changes, CMS estimates that hospital inpatient payments will increase by $3.2 billion in FY 2025. Comments are due June 10.  

Submit Medicare Physician Attestation Statements by May 3

What’s happening: As a condition of participation, Medicare-certified hospitals must complete attestation and acknowledgment of physicians with newly granted admitting privileges in the previous calendar year. 

What else to know: Attestation statements for 2023 should be submitted by May 3. 

CMS Proposes 2.6% Inpatient Prospective Payment System Rate Increase for FY 2025

What’s happening: The Centers for Medicare & Medicaid Services (CMS) has proposed a net increase to base Medicare inpatient payment rates (market basket update) of 2.6% for fiscal year (FY) 2025. 

What else to know: The increase is included in the FY 2025 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system proposed rule. Comments on the proposed rule are due to CMS by June 10. 

CMS Issues Post-Acute Care Payment Proposed Rules

What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and hospices for federal fiscal year (FFY) 2025.  

What else to know: Comments on the proposed rules are due to CMS by 2 p.m. (PT) on May 28.