On 11 April, CMS issued the proposed rule for its financial year 2026 in the in-post probability payment system and long-term care hospital possible payment system.
To know nine things:
1. The CMS proposes a 2.4% increase in payment rates of the in -post hospital for FY 2026 – a 3.2% reflects an increase in offset by 0.8% productivity adjustment in an estimated market basket.
2. The update is expected to increase the payment of $ 4 billion in the hospital, including $ 1.5 billion in the additional medicine, including $ 234 million in hospital payment and new technology add-on payment.
3. Long -term care hospitals are slaughtered to receive 2.6% payment rate update, resulting in net 2.2% payment increase, or approximately $ 52 million in total additional payments.
4. After the decision of a federal court CMS is proposing to discontinue the policy of the low Wage Index Hospital for 2026. A transitional payment exception will be provided for the fairly affected hospitals.
5. Transforming episodes accountable model will be launched in January 2026. The selected acute care hospital will be responsible for episodes-based care for five surgery, through the inverted process, through the insertion process, through post-discharge after 30 days.
6. CMS proposed a change in hospital in the hospital, including:
- Amendment of four existing measures
- Removing four measures (related to social drivers of health equity and health)
- Exceptional exception to update policy
7. Hospital Reading Reduction Program will now include Medicare Advantage Data and Short Performance period from three years to two.
8. For the value-based purchasing program of the hospital, CMS proposes:
- Removal of health equity adjustment from scoring functioning
- Total hip/knee arthroplasty complexity remedy Remedy Risk adjustment model model
9. The proposed rule is open to public comment for 60 days.
Click here for more information on the proposed rule.
