FFY 2026 IPPS Proposed Rule
Toyon's summary of the FY26 IPPS Proposed Rule and discussion of key changes to the Medicare reimbursement landscape, focused on areas directly impacting Medicare cost reporting and provider reimbursement, followed by an analysis and observations of the Proposed Rule.
FFY 2026 IPPS Proposed Rule: Unleashing Prosperity through Deregulation of the Medicare Program
Toyon's summary of Executive Order 14192 and subsequent impact analysis.
FFY 2026 IPPS Proposed Rule: National Medicare IPPS Estimates
Toyon's summary of the national Medicare IPPS estimates as part of the FY26 IPPS Proposed Rule with advice on comments to CMS.
FFY 2026 IPPS Proposed Rule: Provider Rates
Toyon's summary of CMS’s proposed changes to provider rates as part of the FY26 IPPS Proposed Rule.
FFY 2026 IPPS Proposed Rule: Uncompensated Care (UC) DSH
Toyon's summary of CMS’s proposed changes to Medicare UC DSH payments as part of the FY26 IPPS Proposed Rule and recommendations for providers.
FFY 2026 IPPS Proposed Rule: Wage Index
Toyon's summary of changes to the national AHW as part of our discussion of the FY26 IPPS Proposed Rule.
FFY 2026 IPPS Proposed Rule: Graduate Medical Education
Toyon's summary of updates to available FTE slots from hospital closures as part of the FY26 IPPS Proposed Rule.
FFY 2026 IPPS Proposed Rule: Outlier Reconciliation Changes
Reminder of Change Request 13566 and its impact on Medicare outlier payment reconciliations, and recommendations from Toyon for providers for current CCRs.
FFY 2025 IPPS Proposed Rule
Toyon's summary of the FY25 IPPS Proposed Rule, focused on areas directly impacting Medicare cost reporting and provider reimbursement, followed by an analysis and observations of the Proposed Rule.
FFY 2024 IPPS Final Rule
Toyon's summary of the FY24 IPPS Final Rule, focused on areas directly impacting Medicare cost reporting and provider reimbursement for acute care hospitals.
FFY 2024 IPPS Final Rule: National Medicare IPPS Estimates
CMS estimates IPPS hospitals will receive an increase of $2.2 billion compared to FFY 2023.
FFY 2024 IPPS Final Rule: Standardized Base Rates and DRG Weights
CMS adjusted FFY 2024 rates based on FFY 2022 MEDPAR claims and FFY 2021 HCRIS data, while also implementing payment reductions for hospitals not meeting Hospital Inpatient Quality Reporting (IQR) or Promoting Interoperability of Electronic Health Record (EHR) requirements, with decreases in MS-DRG relative weights capped at a maximum reduction of ten percent from FFY 2023 weights.
FFY 2024 IPPS Final Rule: Uncompensated Care (UC) DSH
CMS finalized a decrease in Medicare UC DSH payments by -$950 million, to $6.0 billion in FFY 2024. In FFY 2024, providers will receive a UC DSH payment representing 17.5% of UC Costs, whereby in FFY 2023 providers received 20.2% of UC Costs. CMS is also now using a three-year average of UC cost to determine each DSH hospital’s portion of the fund.
FFY 2024 IPPS Final Rule: Empirical DSH
Discussion of finalized changes to regulations on the inclusion of certain Section 1115 demonstration days in the Medicaid fraction of the empirical DSH calculation, and the impact on reporting of patient days for patients discharged on or after October 1, 2023 (FFY 2024).
FFY 2024 IPPS Final Rule: Wage Index
Discussion of CMS updates to wage index calculation and implementation of a “transition” policy.
FFY 2024 IPPS Final Rule: Graduate Medical Education (GME) and Nursing/Allied Health
CMS finalized the Nursing and Allied Health MA add-on rates and direct GMA MA percent reductions for CY 2022, and finalized that effective for cost reporting periods beginning on or after October 1, 2023, REHs may be considered a non-provider site.