Medicare tweaks hospital payments: Yawn, another fiscal year shuffle
Published Date: 4/30/2025
Proposed Rule
Summary
Starting in fiscal year 2026, hospitals that treat Medicare patients will see updated payment rates and new rules to keep care quality high. Teaching hospitals will get changes to how they’re paid for training new doctors, and long-term care hospitals will have updated payment policies too. These updates aim to make sure hospitals get fair money while improving patient care and meeting new quality standards.
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Acute Hospital Payment Rate Update
Starting in fiscal year 2026, Medicare will revise the inpatient prospective payment system (IPPS) rates that pay for acute care hospitals' operating and capital-related costs. If you get care at a hospital that treats Medicare patients, the way hospitals are paid for inpatient stays will change beginning in fiscal year 2026.
Teaching Hospitals' GME Payment Changes
For fiscal year 2026, Medicare proposes changes related to graduate medical education (GME) payments for teaching hospitals. Teaching hospitals that receive Medicare GME funding will see changes to how they are paid for training new doctors.
Long‑Term Care Hospital Payment Policy Update
Beginning in fiscal year 2026, Medicare will update payment policies and the annual payment rates for the prospective payment system (PPS) that pays long-term care hospitals (LTCHs) for inpatient services. If you receive inpatient care at an LTCH that bills Medicare, those payment rules will be updated.
Changes to Quality Program Requirements
The rule proposes updates and changes to requirements for certain Medicare quality programs starting in fiscal year 2026. These changes are intended to support higher quality care for patients treated at Medicare-participating hospitals.
Personalized for You
How does this regulation affect your finances?
Personalize government policy and PRIA will tell you what this federal register document means for your household, plus every other regulation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-15686, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program.
2026-15652, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2027. As required by statute, this final rule includes the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2027. It also finalizes the third and final of the 3-year phaseout of the rural adjustment, which began in FY 2025. This final rule includes a solicitation for public comments on alternative data sources for the IRF PPS wage index; requires all therapy treatments and/or therapy evaluations to begin no later than 36 hours from midnight on the day of admission; finalizes requirements for the initial Interdisciplinary Team meeting to occur on or before 4 days from the date the patient is admitted; and summarizes a request for information on potential future IRF PPS payment reform. Additionally, this final rule includes updates to the IRF Quality Reporting Program and changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
2026-15562, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027
Starting October 1, 2026, skilled nursing facilities (SNFs) will see updated payment rates and new rules for how Medicare pays them. The Quality Reporting and Value-Based Purchasing programs are also getting tweaks to help improve care. These changes affect SNFs nationwide and could impact how much money they get and how they report quality data.
2026-14897, Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes
Starting October 1, 2026, new rules will change how states handle health care-related taxes under Medicaid. These changes set clear limits on tax amounts based on 2025 levels and will gradually lower those limits in some states by 2027. States and taxpayers should get ready for tighter rules and better oversight that could affect tax collections and Medicaid funding.
2026-14709, Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some typos and technical mistakes in the 2027 health insurance rules under the Affordable Care Act. It mainly affects people and organizations involved in health coverage plans by clarifying when the rules take effect and restoring some important regulation details. These fixes take effect on July 20, 2026, ensuring smoother and clearer health plan operations next year.
2026-14327, Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
Starting in 2027, Medicare and Medicaid are updating how doctors and clinics get paid to better match today’s medical care and laws. This includes new rules for drug price rebates, shared savings programs, and payments for rural and specialty care. These changes affect doctors, patients, and drug makers, aiming to save money and improve care quality.
Previous / Next Documents
Previous: 2025-07310, Petition for Reconsideration of Action in Rulemaking Proceeding
Rick Kaplan, Alison Martin, and Robert Weller, speaking for the National Association of Broadcasters, have asked the Commission to rethink some recent rule changes. These petitions could affect broadcasters by changing how rules apply to them, possibly impacting costs or deadlines. Keep an eye out—this could shift the game for anyone involved in broadcasting soon!
Next: 2025-06298, Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update
Starting October 1, 2025, Medicare is updating how it pays inpatient psychiatric hospitals and units, including changes to rates, wage adjustments, and special payments for teaching and rural facilities. These updates affect hospitals that care for patients with mental health needs and aim to improve payment fairness and quality reporting. Plus, Medicare is tweaking quality rules and asking for ideas to make the program even better!