We are at that point of the regulatory season where CMS is beginning to release the first round of its final rules. Over the past week, CMS has dropped the Inpatient Prospective Payment System (IPPS), Hospice and Skilled Nursing Facility (SNF) final rules and finalized many of its proposals like telehealth services and the payment updates. Keep reading to learn more about the final rules.

FY 2024 IPPS Final Rule

CMS increased inpatient payments by a net 3.1% ($2.2 billion) when compared with FY 2023. CMS finalized a cut in DSH payments of almost $1 billion. Other changes within the rule are below. A CMS fact-sheet on the rule can be found here.

  • Adopt of a new health equity adjustment within the Value-Based Purchasing Program (VBP).
  • Exclude from the Medicaid fraction of DHS payments, patient days for which hospitals received a payment from a Section 1115–based Uncompensated Care (UC) pool. This now finalized policy will have major implications for states that have UCs such as Florida, Kansas, Texas and California.
  • Allow Graduate Medical Education payments for Rural Emergency Hospitals.
  • Continue the low wage index hospital policy for FY 2024 and treat rural reclassified hospitals as geographically rural for the purposes of calculating the wage index.
  • Stop the COVID-19 Treatment Add-on Payments due to the program’s expiration on Sep. 30th.

FY 2024 Hospice Final Rule

CMS increased payments by a net 3.1% ($780 million) when compared to FY 2023 levels. CMS also finalized an updated payment cap per patient of $33,494.01. In addition, the agency finalized its proposal to require that physicians who certify hospice eligibility be enrolled as a Medicare provider or validly opted out. Lastly, CMS finalized its proposal to extend the ability to conduct face-to-face physician recertifications remotely through December 31st, 2024. A CMS fact-sheet on the rule can be found here.

FY 2024 SNF Final Rule

CMS increased payments by a net 4.0%, ($1.4 billion) when compared to FY 2023 levels.
CMS also finalized nearly all proposals for the SNF Quality Reporting Program, including the adoption of two new measures. For the SNF VBP program, the agency will adopt four measures and a health equity scoring adjustment to account for facilities that serve a disproportionate amount of Medicare and Medicaid eligible patients. A CMS fact-sheet on the rule can be found here.