{"description":"Documents matching 'adjust past wage depression'","count":513,"total_pages":26,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=adjust+past+wage+depression&format=json&page=2","results":[{"title":"Adverse Effect Wage Rate Methodology for the Temporary Employment of H-2A Nonimmigrants in Non-Range Occupations in the United States","type":"Rule","abstract":"The Department of Labor (Department or DOL) is issuing this interim final rule (IFR) to amend its regulations governing the certification of agricultural labor or services to be performed by temporary foreign workers in H-2A nonimmigrant status (H-2A workers). Specifically, the Department is revising the methodology for determining the hourly Adverse Effect Wage Rates (AEWRs) for non-range occupations by using wage data reported for each U.S. state and territory by the Department's Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics (OEWS) survey. For the vast majority of H-2A job opportunities, the Department will use OEWS survey data to establish AEWRs applicable to five Standard Occupational Classification (SOC) codes combining the most common field and livestock worker occupations previously measured by the U.S. Department of Agriculture's (USDA) Farm Labor Survey (FLS), which covered six SOC codes. These AEWRs will be divided into two skill-based categories to account for wage differentials arising from qualifications contained in the employer's job offer. For all other occupations, the Department will use the OEWS survey to determine two skill-based AEWRs for each SOC code to reflect wage differentials. The threshold determination for assigning the SOC code(s) and applicable skill-based AEWR will be based on the duties performed for the majority of the workdays during the contract period and qualifications contained in the employer's job offer. Finally, to address differences in compensation between most U.S. workers and H-2A workers who receive employer-provided housing at no cost, the Department will implement a standard adjustment factor to the AEWR to account for this non-monetary compensation that employers will apply when compensating H-2A workers under temporary agricultural labor certifications.","document_number":"2025-19365","html_url":"https://www.federalregister.gov/documents/2025/10/02/2025-19365/adverse-effect-wage-rate-methodology-for-the-temporary-employment-of-h-2a-nonimmigrants-in-non-range","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-10-02/pdf/2025-19365.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-19365.pdf?1759263310","publication_date":"2025-10-02","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employment and Training Administration","name":"Employment and Training Administration","id":133,"url":"https://www.federalregister.gov/agencies/employment-and-training-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/133","parent_id":271,"slug":"employment-and-training-administration"}],"excerpts":"(noting the D.C. Circuit observed there is no “statutory requirement to <span class=\"match\">adjust</span> for <span class=\"match\">past</span> <span class=\"match\">wage</span> <span class=\"match\">depression</span>”); 54 FR at 28046-47 (Jul. 5, 1989) (“IRCA only requires that the AEWR prevent future adverse effect from the use of foreign workers, not compensate for <span class=\"match\">past</span> effect.”)\n \n \n \n \n Further, the INA does not require the Department to prove or rely on the existence of <span class=\"match\">past</span> adverse effect but instead is focused on prevent[ing] future adverse effect.\n 12 \n \n Regardless “of any <span class=\"match\">past</span> adverse effect that the use of low-skilled foreign labor may or may not"},{"title":"Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies","type":"Proposed Rule","abstract":"This proposed rule would set forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this proposed rule discusses the behavior adjustment and proposes a temporary behavior adjustment and proposes to recalibrate the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low- utilization payment adjustment (LUPA) thresholds for CY 2027. Additionally, this proposed rule discusses the provision of home health palliative care services and includes a request for information (RFI) on a home health specific wage index. This rule would also propose changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and expanded Home Health Value Based Purchasing (HHVBP) Model. Lastly, the rule would--clarify the application of the DMEPOS face-to- face encounter requirements for the replacement of DMEPOS items; make changes to the provider and supplier enrollment requirements; make changes regarding DME benefit expansion for infusion pumps and drugs; and discuss collection of information requirement changes regarding the DMEPOS Competitive Bidding Program (CBP) country of origin.","document_number":"2026-13602","html_url":"https://www.federalregister.gov/documents/2026/07/06/2026-13602/calendar-year-2027-home-health-prospective-payment-system-hh-pps-rate-update-requirements-for-the-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-07-06/pdf/2026-13602.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-13602.pdf?1782936912","publication_date":"2026-07-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"subgroups to include 21 low comorbidity <span class=\"match\">adjustment</span> subgroups and 100 high comorbidity <span class=\"match\">adjustment</span> interaction subgroups. The proposed CY 2027 low comorbidity <span class=\"match\">adjustment</span> subgroups and the high comorbidity <span class=\"match\">adjustment</span> interaction subgroups including those diagnoses within each of these comorbidity <span class=\"match\">adjustments</span> are shown in tables 21 and 22. The proposed CY 2027 low comorbidity <span class=\"match\">adjustment</span> subgroups and the high comorbidity <span class=\"match\">adjustment</span> interaction subgroups including those diagnoses within each of these comorbidity <span class=\"match\">adjustments</span> will also be posted on the HHA Center"},{"title":"Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2025 and Updates to the IRF Quality Reporting Program","type":"Rule","abstract":"This final action updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2025. As required by statute, this final action includes the classification and weighting factors for the IRF prospective payment system's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2025. We are updating the Office of Management and Budget (OMB) market area delineations for the IRF prospective payment system (PPS) wage index and applying a 3-year phase-out of the rural adjustment. This rule also includes updates for the IRF Quality Reporting Program (QRP).","document_number":"2024-16911","html_url":"https://www.federalregister.gov/documents/2024/08/06/2024-16911/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-06/pdf/2024-16911.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-16911.pdf?1722456915","publication_date":"2024-08-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"specific hospital <span class=\"match\">wage</span> index data, we will continue using the average <span class=\"match\">wage</span> indexes of all urban areas within the State to serve as a reasonable proxy for the <span class=\"match\">wage</span> index of that urban CBSA as proposed and finalized in FY 2006 (70 FR 47927). For FY 2025, the only urban area without <span class=\"match\">wage</span> index data available is CBSA 25980, Hinesville Fort Stewart, GA. \n We invited public comment on the proposed <span class=\"match\">Wage</span> <span class=\"match\">Adjustment</span> for FY 2025. The following is a summary of the public comments received on the proposed revisions to the <span class=\"match\">Wage</span> <span class=\"match\">Adjustment</span> for FY 2025: \n \n Comment:"},{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability","type":"Rule","abstract":"This final rule revises standards relating to denial of coverage for failure to pay past-due premium; excludes Deferred Action for Childhood Arrivals recipients from the definition of \"lawfully present;\" establishes the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; revises the Exchange automatic reenrollment hierarchy; revises standards related to the annual open enrollment period and special enrollment periods; revises standards relating to failure to file and reconcile, income eligibility verifications for premium tax credits and cost-sharing reductions, annual eligibility redeterminations, de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements, and income-based cost-sharing reduction plan variations. This final rule also revises the premium adjustment percentage methodology and prohibits issuers of coverage subject to EHB requirements from providing coverage for specified sex-trait modification procedures as an EHB.","document_number":"2025-11606","html_url":"https://www.federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-06-25/pdf/2025-11606.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-11606.pdf?1750709712","publication_date":"2025-06-25","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"applying the <span class=\"match\">past</span>-due premium policy with regard to claims history would discriminate based on health status, we do not adopt the commenter's suggestion to require issuers that adopt the <span class=\"match\">past</span>-due premium policy to create exceptions for instances in which no claims are incurred during the period in which <span class=\"match\">past</span>-due premiums are owed. These practices are not permitted under this final rule. \n \n Comment: \n One commenter asked how the policy related to <span class=\"match\">past</span>-due premiums would impact claims payment.\n \n \n Response: \n If an individual pays <span class=\"match\">past</span>-due premiums"},{"title":"Discontinuance of Information Collections","type":"Notice","abstract":"This notice announces the National Agricultural Statistics Service (NASS) has discontinued the information collection for both the Mink Survey (OMB Control Number 0535-0212) and the Agricultural Labor Survey (OMB Control Number 0535-0109), as these collections are deemed duplicative and/or no longer necessary. This action is taken under the provisions of the Paperwork Reduction Act (PRA) as part of the government's efforts to improve efficiency and eliminate unnecessary burdens.","document_number":"2025-16831","html_url":"https://www.federalregister.gov/documents/2025/09/03/2025-16831/discontinuance-of-information-collections","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-09-03/pdf/2025-16831.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-16831.pdf?1756480508","publication_date":"2025-09-03","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"National Agricultural Statistics Service","name":"National Agricultural Statistics Service","id":303,"url":"https://www.federalregister.gov/agencies/national-agricultural-statistics-service","json_url":"https://www.federalregister.gov/api/v1/agencies/303","parent_id":12,"slug":"national-agricultural-statistics-service"}],"excerpts":"however, has computed this rate, known as the Adverse Effect <span class=\"match\">Wage</span> Rate (AEWR), without the FLS in the <span class=\"match\">past</span>. To illustrate, DOL in rulemaking reported that the use of the FLS, coinciding with an increase in illegal immigration, had diminished its utility for AEWR purposes: “The Department chose at that time to use USDA data to set AEWRs largely because it believed that USDA's aggregation of <span class=\"match\">wage</span> data at broad regional levels would immunize the survey from the effects of any localized <span class=\"match\">wage</span> <span class=\"match\">depression</span> that might exist. 54 FR 28043. As discussed above, however"},{"title":"Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update","type":"Proposed Rule","abstract":"This rulemaking proposes to update the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPFs), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. This rulemaking also proposes refinement of the IPF PPS outlier policy. These changes would be effective for IPF discharges occurring during the fiscal year beginning October 1, 2026, through September 30, 2027. We are also proposing the implementation of a standardized IPF patient assessment instrument, and the removal of two measures used in the Inpatient Psychiatric Facilities Quality Reporting Program.","document_number":"2026-06675","html_url":"https://www.federalregister.gov/documents/2026/04/07/2026-06675/medicare-program-fy-2027-inpatient-psychiatric-facilities-prospective-payment-system-rate-update","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-07/pdf/2026-06675.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-06675.pdf?1775164507","publication_date":"2026-04-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"pre-reclassified IPPS hospital <span class=\"match\">wage</span> index from the FY concurrent with the IPF FY as the basis for the IPF <span class=\"match\">wage</span> index. For example, the FY 2020 IPF <span class=\"match\">wage</span> index was based on the FY 2020 pre-floor, pre-reclassified IPPS hospital <span class=\"match\">wage</span> index rather than on the FY 2019 pre-floor, pre-reclassified IPPS hospital <span class=\"match\">wage</span> index. \n We explained in the FY 2020 proposed rule (84 FR 16973), that using the concurrent pre-floor, pre-reclassified IPPS hospital <span class=\"match\">wage</span> index will result in the most up-to-date <span class=\"match\">wage</span> data being the basis for the IPF <span class=\"match\">wage</span> index. We noted that it would"},{"title":"Medicare Program; FY 2025 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update","type":"Rule","abstract":"This final action updates the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. This final action also revises the patient-level adjustment factors, the Emergency Department adjustment, and the payment amount for electroconvulsive therapy. These changes will be effective for IPF discharges occurring during the fiscal year (FY) beginning October 1, 2024 through September 30, 2025 (FY 2025). In addition, this final action finalizes the adoption of a new quality measure. It does not finalize modifications to the reporting requirements under the IPF Quality Reporting Program beginning with the FY 2027 payment determination. Furthermore, this final action summarizes comments received through Requests for Information regarding potential future revisions to the IPF PPS facility-level adjustments and regarding the development of a standardized IPF Patient Assessment Instrument.","document_number":"2024-16909","html_url":"https://www.federalregister.gov/documents/2024/08/07/2024-16909/medicare-program-fy-2025-inpatient-psychiatric-facilities-prospective-payment-system-rate-update","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-07/pdf/2024-16909.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-16909.pdf?1722456916","publication_date":"2024-08-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"included <span class=\"match\">adjustment</span>-related variables and control variables. We explained that <span class=\"match\">adjustment</span>-related variables are used for <span class=\"match\">adjusting</span> payment, and we proposed to revise the IPF PPS patient-level <span class=\"match\">adjustment</span> factors based on the regression results for many of the <span class=\"match\">adjustment</span>-related variables in the model. We further explained that control variables are used to account for variation in the dependent variable that is associated with factors outside the <span class=\"match\">adjustment</span> factors of the payment model. \n (1) <span class=\"match\">Adjustment</span>-Related Variables \n Patient-level <span class=\"match\">adjustment</span>-related"},{"title":"Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2025 and Updates to the IRF Quality Reporting Program","type":"Proposed Rule","abstract":"This rule proposes updates to the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2025. As required by statute, this proposed rule includes the classification and weighting factors for the IRF prospective payment system's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2025. We are proposing updates to the Office of Management and Budget (OMB) market area delineations for the IRF prospective payment system (PPS) wage index and proposing to apply a 3-year phase-out of the rural adjustment. This rule also includes proposals for the IRF Quality Reporting Program (QRP).","document_number":"2024-06550","html_url":"https://www.federalregister.gov/documents/2024/03/29/2024-06550/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06550.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-06550.pdf?1711570520","publication_date":"2024-03-29","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"portion of the proposed Federal payment. \n <span class=\"match\">Adjusting</span> the proposed <span class=\"match\">wage</span>-<span class=\"match\">adjusted</span> Federal payment by the facility-level <span class=\"match\">adjustments</span> involves several steps. First, we take the <span class=\"match\">wage</span>-<span class=\"match\">adjusted</span> prospective payment and multiply it by the appropriate rural and LIP <span class=\"match\">adjustments</span> (if applicable). Second, to determine the appropriate amount of additional payment for the teaching status <span class=\"match\">adjustment</span> (if applicable), we multiply the teaching status <span class=\"match\">adjustment</span> (0.0784, in this example) by the <span class=\"match\">wage</span>-<span class=\"match\">adjusted</span> and rural-<span class=\"match\">adjusted</span> amount (if applicable). Finally, we add the additional"},{"title":"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2025","type":"Rule","abstract":"This final rule finalizes changes and updates to the policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year (FY) 2025. First, we are rebasing and revising the SNF market basket to reflect a 2022 base year. Next, we update the wage index used under the SNF PPS to reflect data collected during the most recent decennial census. Additionally, we finalize several technical revisions to the code mappings used to classify patients under the Patient Driven Payment Model (PDPM) to improve payment and coding accuracy. This final rule also updates the requirements for the SNF Quality Reporting Program and the SNF Value- Based Purchasing Program. Finally, we also are revising CMS' enforcement authority for imposing civil money penalties (CMPs) and including revisions to strengthen nursing home enforcement regulations.","document_number":"2024-16907","html_url":"https://www.federalregister.gov/documents/2024/08/06/2024-16907/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-06/pdf/2024-16907.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-16907.pdf?1722456916","publication_date":"2024-08-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":" BILLING CODE 4120-01-C \n D. <span class=\"match\">Wage</span> Index <span class=\"match\">Adjustment</span> \n Section 1888(e)(4)(G)(ii) of the Act requires that we <span class=\"match\">adjust</span> the Federal rates to account for differences in area <span class=\"match\">wage</span> levels, using a <span class=\"match\">wage</span> index that the Secretary determines appropriate. Since the inception of the SNF PPS, we have used hospital inpatient <span class=\"match\">wage</span> data in developing a <span class=\"match\">wage</span> index to be applied to SNFs. We will continue this practice for FY 2025, as we continue to believe that in the absence of SNF-specific <span class=\"match\">wage</span> data, using the hospital inpatient <span class=\"match\">wage</span> index data is appropriate and"},{"title":"Medicare Program; FY 2025 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update","type":"Proposed Rule","abstract":"This rulemaking proposes to update the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. This rulemaking also proposes to revise the patient-level adjustment factors, the Emergency Department adjustment, and the payment amount for electroconvulsive therapy. These proposed changes would be effective for IPF discharges occurring during the fiscal year beginning October 1, 2024 through September 30, 2025 (FY 2025). In addition, this proposed rule seeks to adopt a new quality measure and modify reporting requirements under the IPF Quality Reporting Program beginning with the FY 2027 payment determination. Furthermore, this proposed rule solicits comments through Requests for Information (RFIs) regarding potential future revisions to the IPF PPS facility-level adjustments and regarding the development of a standardized IPF Patient Assessment Instrument.","document_number":"2024-06764","html_url":"https://www.federalregister.gov/documents/2024/04/03/2024-06764/medicare-program-fy-2025-inpatient-psychiatric-facilities-prospective-payment-system-rate-update","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-03/pdf/2024-06764.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-06764.pdf?1711656915","publication_date":"2024-04-03","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"IPF PPS final rule (69 FR 66933 through 66936).\n \n The patient-level <span class=\"match\">adjustments</span> include age, Diagnosis-Related Group (DRG) assignment, and comorbidities, as well as <span class=\"match\">adjustments</span> to reflect higher per diem costs at the beginning of a patient's IPF stay and lower costs for later days of the stay. Facility-level <span class=\"match\">adjustments</span> include <span class=\"match\">adjustments</span> for the IPF's <span class=\"match\">wage</span> index, rural location, teaching status, a cost-of-living <span class=\"match\">adjustment</span> for IPFs located in Alaska and Hawaii, and an <span class=\"match\">adjustment</span> for the presence of a qualifying emergency department (ED). \n \n The"},{"title":"Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model","type":"Rule","abstract":"This final rule updates and revises the End-Stage Renal Disease (ESRD) Prospective Payment System for calendar year 2026. This rule also includes updates to the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. In addition, this rule updates the requirements for the ESRD Quality Incentive Program and terminates and modifies requirements for the ESRD Treatment Choices Model.","document_number":"2025-20681","html_url":"https://www.federalregister.gov/documents/2025/11/24/2025-20681/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-11-24/pdf/2025-20681.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-20681.pdf?1763673309","publication_date":"2025-11-24","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"• \n Annual update to the <span class=\"match\">wage</span> index: \n We <span class=\"match\">adjust</span> the ESRD PPS <span class=\"match\">wage</span> index on an annual basis using the most current mean hourly <span class=\"match\">wage</span> data for occupations related to the furnishing of renal dialysis services from the Bureau of Labor Statistics (BLS) Occupational Employment and <span class=\"match\">Wage</span> Statistics (OEWS) program and occupational mix data from the most recent full CY of freestanding ESRD facility Medicare cost reports. This <span class=\"match\">wage</span> index uses the latest core-based statistical area (CBSA) delineations to account for differing <span class=\"match\">wage</span> levels in areas in which ESRD"},{"title":"Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2026 based on our continuing experience with these systems. We also describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. This proposed rule would also update and refine the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, Overall Hospital Quality Star Rating, and hospitals to make public their standard charge information and enforcement of hospital price transparency. This rule also contains requests for information on measure concepts regarding Well-Being and Nutrition for consideration in future years for all three programs (OQR, REHQR, and ASCQR; expanding the method to control for unnecessary increases in the volume of covered OPD services to on- campus clinic visits; software as a service; and adjusting payment under the OPPS for services predominately performed in the ambulatory surgical center or physician office settings.","document_number":"2025-13360","html_url":"https://www.federalregister.gov/documents/2025/07/17/2025-13360/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-17/pdf/2025-13360.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-13360.pdf?1752610509","publication_date":"2025-07-17","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"that the proposed FY 2026 IPPS <span class=\"match\">wage</span> indexes continue to reflect a number of <span class=\"match\">adjustments</span> implemented in <span class=\"match\">past</span> years, including, but not limited to, reclassification of hospitals to different geographic areas, the rural floor provisions, the imputed floor <span class=\"match\">wage</span> index <span class=\"match\">adjustment</span> in all-urban states, an <span class=\"match\">adjustment</span> for occupational mix, an <span class=\"match\">adjustment</span> to the <span class=\"match\">wage</span> index based on commuting patterns of employees (the out-migration <span class=\"match\">adjustment</span>), and the permanent 5 percent cap on any decrease to a hospital's <span class=\"match\">wage</span> index from its <span class=\"match\">wage</span> index in a prior FY. Beginning"},{"title":"Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model","type":"Proposed Rule","abstract":"This proposed rule would update and revise the End-Stage Renal Disease (ESRD) Prospective Payment System for calendar year 2026. This rule also proposes to update the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. In addition, this rule proposes to update requirements for the ESRD Quality Incentive Program and to terminate and modify requirements for the ESRD Treatment Choices Model.","document_number":"2025-12368","html_url":"https://www.federalregister.gov/documents/2025/07/02/2025-12368/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-02/pdf/2025-12368.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-12368.pdf?1751314516","publication_date":"2025-07-02","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"instead use the May 2023 BLS OEWS means hourly <span class=\"match\">wage</span> estimates for the occupations in question and <span class=\"match\">adjust</span> them to be comparable with 2024 <span class=\"match\">wage</span> values by multiplying the <span class=\"match\">wage</span> estimates by an <span class=\"match\">adjustment</span> factor based on the average change in national BLS OEWS wages for each occupation in the NEFOM. The <span class=\"match\">adjustment</span> factors we have applied in our proposed CY 2026 ESRD PPS <span class=\"match\">wage</span> index are the percent change of national average <span class=\"match\">wage</span> for the occupation in question for 2024 compared to the national average <span class=\"match\">wage</span> for that occupation for 2023 from the May 2024"},{"title":"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027","type":"Proposed Rule","abstract":"This rule proposes changes and updates to the policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year 2027. This proposed rule also updates the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program.","document_number":"2026-06674","html_url":"https://www.federalregister.gov/documents/2026/04/07/2026-06674/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-07/pdf/2026-06674.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-06674.pdf?1775164507","publication_date":"2026-04-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"62 \n 79.97 \n \n \n \n \n D. <span class=\"match\">Wage</span> Index <span class=\"match\">Adjustment</span> \n \n Section 1888(e)(4)(G)(ii) of the Act requires that we <span class=\"match\">adjust</span> the Federal payment rates to account for differences in area <span class=\"match\">wage</span> levels, using a <span class=\"match\">wage</span> index that the Secretary determines appropriate. Since the inception of the SNF PPS, we have used hospital inpatient <span class=\"match\">wage</span> data in developing a <span class=\"match\">wage</span> index to be applied to SNFs. We will continue this practice for FY 2027, as we continue to believe that in the absence of SNF-specific <span class=\"match\">wage</span> data, using the hospital inpatient <span class=\"match\">wage</span> index data is appropriate"},{"title":"Alien Registration Form and Evidence of Registration","type":"Rule","abstract":"On March 12, 2025, DHS issued an interim final rule (IFR) with request for comments amending DHS regulations to designate a new registration form for aliens to comply with statutory alien registration and fingerprinting provisions. Unregistered aliens may use this general registration form to satisfy their statutory obligations. This final rule responds to public comments, amends DHS regulations to adjust the lists of forms and processes that may serve as registration forms and evidence of alien registration, and seeks comments on other potential changes to the regulations relating to alien registration and fingerprinting.","document_number":"2026-13057","html_url":"https://www.federalregister.gov/documents/2026/06/29/2026-13057/alien-registration-form-and-evidence-of-registration","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-29/pdf/2026-13057.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-13057.pdf?1782418509","publication_date":"2026-06-29","agencies":[{"raw_name":"DEPARTMENT OF HOMELAND SECURITY","name":"Homeland Security Department","id":227,"url":"https://www.federalregister.gov/agencies/homeland-security-department","json_url":"https://www.federalregister.gov/api/v1/agencies/227","parent_id":null,"slug":"homeland-security-department"}],"excerpts":"use the mean hourly <span class=\"match\">wage</span> of all occupations ($32.66).\n 121 \n \n To estimate total compensation we multiply the expected <span class=\"match\">wage</span> by the compensation to <span class=\"match\">wage</span> ratio for civilian employees (1.46).\n 122 \n \n This results in an estimated mean hourly total compensation of $47.68.\n 123 \n \n \n \n \n 121 \n  \n See \n Bureau of Labor Statistics, U.S. Department of Labor (DOL), “Occupational Employment and Wages News Release—Occupational Employment and Wages—May 2024” Table 1. National employment and <span class=\"match\">wage</span> data from the Occupation employment and <span class=\"match\">Wage</span> Statistics survey by"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); update and make changes to requirements for certain quality programs; and make other policy-related changes.","document_number":"2026-07203","html_url":"https://www.federalregister.gov/documents/2026/04/14/2026-07203/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-14/pdf/2026-07203.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-07203.pdf?1775852113","publication_date":"2026-04-14","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"2. Proposed Changes to the Hospital <span class=\"match\">Wage</span> Index for Acute Care Hospitals \n In section III of the preamble of the proposed rule, we proposed revisions to the <span class=\"match\">wage</span> index for acute care hospitals and the annual update of the <span class=\"match\">wage</span> data. Specific issues addressed include, but are not limited to, the following: \n • The proposed FY 2027 <span class=\"match\">wage</span> index update using <span class=\"match\">wage</span> data from cost reporting periods beginning in FY 2023. \n • Calculation, analysis, and implementation of the proposed occupational mix <span class=\"match\">adjustment</span> to the <span class=\"match\">wage</span> index for acute care hospitals for"},{"title":"Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027 based on our continuing experience with these systems. We also describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting Program and the Ambulatory Surgical Center Quality Reporting Program. There are no changes to the Rural Emergency Hospital Quality Reporting Program. We propose to expand the prior authorization requirement to include additional Botulinum Toxin Injection services. We also propose to implement certain provisions of the Consolidated Appropriations Act, 2026, for off-campus outpatient departments of a provider. In addition, this proposed rule announces notices of closure of teaching hospitals and opportunities to apply for available slots. This rule also requests information regarding potential approaches to improve comparability and standardization, particularly for complex contracting methodologies, of the HPT information reported in machine- readable files and consumer-friendly displays. We propose hospital AOs with deeming authority to assess compliance with certain Emergency Medical Treatment and Labor Act (EMTALA) administrative requirements during accreditation and reaccreditation surveys. Finally, we are soliciting comments on a potential separate payment under the Inpatient Prospective Payment System (IPPS) for domestic procurement of personal protective equipment and essential medicines.","document_number":"2026-13656","html_url":"https://www.federalregister.gov/documents/2026/07/07/2026-13656/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-07-07/pdf/2026-13656.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-13656.pdf?1782996328","publication_date":"2026-07-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"that the proposed FY 2027 IPPS <span class=\"match\">wage</span> indexes continue to reflect a number of <span class=\"match\">adjustments</span> implemented in <span class=\"match\">past</span> years, including, but not limited to, an <span class=\"match\">adjustment</span> for occupational mix, reclassification of hospitals to different geographic areas, the rural floor provisions, the imputed floor <span class=\"match\">wage</span> index <span class=\"match\">adjustment</span> in all-urban States, an <span class=\"match\">adjustment</span> to the <span class=\"match\">wage</span> index based on commuting patterns of hospital employees (the out-migration <span class=\"match\">adjustment</span>), the 5 percent cap on any decrease to a hospital's <span class=\"match\">wage</span> index from its <span class=\"match\">wage</span> index in a prior FY, and the transitional"},{"title":"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2025","type":"Proposed Rule","abstract":"This rule proposes changes and updates to the policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for FY 2025. First, we are proposing to rebase and revise the SNF market basket to reflect a 2022 base year. Next, we are proposing to update the wage index used under the SNF PPS to reflect data collected during the most recent decennial census. Additionally, we are proposing several technical revisions to the code mappings used to classify patients under the Patient Driven Payment Model (PDPM) to improve payment and coding accuracy. Finally, this proposed rule includes a Request for Information (RFI) on potential updates to the Non-Therapy Ancillary (NTA) component of PDPM. This rulemaking also proposes to update the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program. We are also proposing to expand CMS' enforcement authority for imposing civil money penalties (CMPs). Finally, this proposed rule includes proposals to strengthen nursing home enforcement requirements.","document_number":"2024-06812","html_url":"https://www.federalregister.gov/documents/2024/04/03/2024-06812/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-03/pdf/2024-06812.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-06812.pdf?1711656915","publication_date":"2024-04-03","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":" 0.62 \n 75.53 \n \n \n \n \n \n D. <span class=\"match\">Wage</span> Index <span class=\"match\">Adjustment</span> \n Section 1888(e)(4)(G)(ii) of the Act requires that we <span class=\"match\">adjust</span> the Federal rates to account for differences in area <span class=\"match\">wage</span> levels, using a <span class=\"match\">wage</span> index that the Secretary determines appropriate. Since the inception of the SNF PPS, we have used hospital inpatient <span class=\"match\">wage</span> data in developing a <span class=\"match\">wage</span> index to be applied to SNFs. We will continue this practice for FY 2025, as we continue to believe that in the absence of SNF-specific <span class=\"match\">wage</span> data, using the hospital inpatient <span class=\"match\">wage</span> index data is appropriate and"},{"title":"Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies","type":"Rule","abstract":"This final rule will set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also finalizes a new standard for an acceptance-to-service policy in the HH conditions of participation (CoPs). Lastly, it updates provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.","document_number":"2024-25441","html_url":"https://www.federalregister.gov/documents/2024/11/07/2024-25441/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-07/pdf/2024-25441.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25441.pdf?1730492128","publication_date":"2024-11-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"meet the criteria for a payment <span class=\"match\">adjustment</span>.\n \n \n Final Decision: \n We are finalizing the updated comorbidity <span class=\"match\">adjustment</span> subgroups and the high comorbidity <span class=\"match\">adjustment</span> interactions using CY 2023 home health data. For CY 2025, the final updated comorbidity <span class=\"match\">adjustment</span> subgroups include 22 low comorbidity <span class=\"match\">adjustment</span> subgroups as identified in table 9 and 94 high comorbidity <span class=\"match\">adjustment</span> interaction subgroups as identified in table 10. The final CY 2025 low comorbidity <span class=\"match\">adjustment</span> subgroups and the high comorbidity <span class=\"match\">adjustment</span> interaction subgroups including"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2026 Rates; Changes to the FY 2025 IPPS Rates Due to Court Decision; Requirements for Quality Programs; and Other Policy Changes; Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization","type":"Rule","abstract":"This final rule revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; makes changes relating to Medicare graduate medical education (GME) for teaching hospitals; updates the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); updates and makes changes to requirements for certain quality programs; and makes other policy- related changes. We are also finalizing the provisions of the interim final action with comment period regarding the changes to the FY 2025 IPPS rates due to the court decision in Bridgeport Hosp. v. Becerra. Lastly, it finalizes certain updates to the ONC Health Information Technology (IT) Certification Program.","document_number":"2025-14681","html_url":"https://www.federalregister.gov/documents/2025/08/04/2025-14681/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-04/pdf/2025-14681.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-14681.pdf?1753992911","publication_date":"2025-08-04","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"preamble of this final rule. \n a. Transition for the Discontinuation of the Low <span class=\"match\">Wage</span> Index Hospital Policy \n To help mitigate growing <span class=\"match\">wage</span> index disparities between high <span class=\"match\">wage</span> and low <span class=\"match\">wage</span> hospitals, in the FY 2020 IPPS/LTCH PPS rule (84 FR 42326 through 42332), we adopted a policy to increase the <span class=\"match\">wage</span> index values for certain hospitals with low <span class=\"match\">wage</span> index values (the low <span class=\"match\">wage</span> index hospital policy). This policy was adopted in a budget neutral manner through an <span class=\"match\">adjustment</span> applied to the standardized amounts for all hospitals. We indicated our intention"}]}