Prospective Payment System

Members-Only Summaries Detail Post-Acute Care, Psychiatric Facility Payment Provisions for FFY 2026

What’s happening: Summaries of the inpatient rehabilitation facility (IRF) prospective payment system (PPS), skilled-nursing facility (SNF) PPS, hospice wage index, and inpatient psychiatric facility (IPF) PPS proposed rules are now available.  

What else to know: The members-only summaries, prepared for CHA by Health Policy Alternatives, Inc., describe Medicare PPS proposals for federal fiscal year (FFY) 2026. 

CMS Proposes Inadequate IPPS Update for FFY 2026

What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) released the federal fiscal year (FFY) 2026 inpatient prospective payment system (IPPS) proposed rule — which falls short of what hospitals need to keep up with rising costs and health care needs.   

What else to know: As a result of all proposed changes, CMS estimates that hospital inpatient payments will increase by $4 billion in FFY 2026. Comments on the proposed rule are due June 10.   

2025 ESRD PPS Final Rule Members-Only Summary Available Now

What’s happening: A members-only summary of the Centers for Medicare & Medicaid Services’ calendar year (CY) 2025 end-stage renal disease (ESRD) prospective payment system (PPS) final rule, prepared by Health Policy Alternatives, Inc., is available.   

What else to know: The regulation is effective Jan. 1, 2025.