{"description":"Documents matching 'transplant programs organ organizations end-stage'","count":368,"total_pages":19,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=transplant+programs+organ+organizations+end-stage&format=json&page=2","results":[{"title":"Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model","type":"Proposed Rule","abstract":"This proposed rule would update and revise the Increasing Organ Transplant Access (IOTA) Model for Performance Year (PY) 2.","document_number":"2025-22543","html_url":"https://www.federalregister.gov/documents/2025/12/11/2025-22543/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-11/pdf/2025-22543.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-22543.pdf?1765314907","publication_date":"2025-12-11","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":"FOR FURTHER INFORMATION CONTACT: \n \n \n CMMItransplant@cms.hhs.gov, \n for questions related to the Increasing <span class=\"match\">Organ</span> <span class=\"match\">Transplant</span> Access Model.\n \n Thomas Duvall, (410) 786-8887, for questions related to the Increasing <span class=\"match\">Organ</span> <span class=\"match\">Transplant</span> Access Model. \n Christina McCormick, (410) 786-4012, for questions related to the Increasing <span class=\"match\">Organ</span> <span class=\"match\">Transplant</span> Access Model. \n Lina Gebremariam, (410) 786-8893, for questions related to the Increasing <span class=\"match\">Organ</span> <span class=\"match\">Transplant</span> Access Model. \n \n \n \n SUPPLEMENTARY INFORMATION: \n \n \n Inspection of Public Comments: \n All comments received"},{"title":"Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model","type":"Rule","abstract":"This final rule will update and revise the Increasing Organ Transplant Access (IOTA) Model for Performance Year (PY) 2. This final rule also includes a technical correction to the regulatory text.","document_number":"2026-10890","html_url":"https://www.federalregister.gov/documents/2026/06/01/2026-10890/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-01/pdf/2026-10890.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-10890.pdf?1779999311","publication_date":"2026-06-01","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":"patients on the waiting list and ultimately decide to accept donor recipients as <span class=\"match\">transplant</span> candidates (89 FR 96303). Kidney <span class=\"match\">transplant</span> hospitals play a key role in managing <span class=\"match\">transplant</span> waitlists and patient, family, and caregiver readiness. They are also responsible for the coordination and planning of kidney <span class=\"match\">transplantation</span> with the <span class=\"match\">organ</span> procurement <span class=\"match\">organizations</span> (OPO) and donor facilities, staffing and preparation for kidney <span class=\"match\">transplantation</span>, and oversight of post-<span class=\"match\">transplant</span> patient care, and they are largely responsible for managing the living donation"},{"title":"Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Conditions for Coverage","type":"Proposed Rule","abstract":"This proposed rule would revise the Conditions for Coverage for Organ Procurement Organizations (OPOs) to clarify outstanding procedural questions and enable OPOs to make better informed decisions to achieve high performance resulting in the successful procurement, distribution, and transplantation of more life-saving organs. This rule would revise definitions, add new Quality Assessment Performance Improvement (QAPI) requirements related to medically complex organs and donors, revise the designation requirements for OPOs, clarify when an OPO's service area is open for competition, and update the process for appeals. It also includes a discussion of factors we would consider when selecting a successor OPO during a competition under the tiered approach to re-certification. We are committed to holding all OPOs accountable for their performance and this proposed rule does not revise the focus on improving the volume of donors and transplants assessed in the outcome measures or the tier structure used for re- certification and de-certification of OPOs.","document_number":"2026-01833","html_url":"https://www.federalregister.gov/documents/2026/01/30/2026-01833/medicare-and-medicaid-programs-organ-procurement-organizations-conditions-for-coverage-revisions-to","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-30/pdf/2026-01833.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-01833.pdf?1769616910","publication_date":"2026-01-30","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":"stem cell <span class=\"match\">transplantation</span>. Hum Hered. 2013;76(3-4):178-86. doi: 10.1159/000358798. Epub 2014 May 21. PMID: 24861862.\n \n \n The <span class=\"match\">transplantation</span> rate is calculated as the number of <span class=\"match\">organs</span> <span class=\"match\">transplanted</span> from donors in the DSA as a percentage of the donor potential. <span class=\"match\">Organs</span>, including pancreatic islet cells, <span class=\"match\">transplanted</span> into patients on the <span class=\"match\">Organ</span> Procurement and <span class=\"match\">Transplantation</span> Network (OPTN) waiting list as part of research are included in the <span class=\"match\">organ</span> <span class=\"match\">transplantation</span> rate. Pancreata that are used in islet cell research are also included. The <span class=\"match\">organ</span> transplantation"},{"title":"Organ Procurement and Transplantation: Implementation of the HIV Organ Policy Equity (HOPE) Act","type":"Rule","abstract":"The Department of Health and Human Services (HHS) amends the regulations implementing the National Organ Transplant Act of 1984, as amended (NOTA), to remove clinical research and institutional review board (IRB) requirements (\"research and IRB requirements\") for transplantation of kidneys and livers from donors with human immunodeficiency virus (HIV) to recipients with HIV. As allowed by the HIV Organ Policy Equity (HOPE) Act, the Secretary of HHS determines that participation in such clinical research should no longer be a requirement for transplantation of kidneys and livers from donors with HIV to recipients with HIV. This final rule serves as publication of the Secretary's determination and amends the regulations to reflect this determination. This final rule also serves as publication of the Secretary's direction to the Organ Procurement and Transplantation Network (OPTN) to adopt and use standards of quality with respect to kidneys and livers from donors with HIV to ensure that HOPE Act kidney and liver transplants are subject to OPTN policies that are consistent with NOTA, and in a way that ensures the revised requirements for transplantation of such organs will not reduce the safety of organ transplantation.","document_number":"2024-27410","html_url":"https://www.federalregister.gov/documents/2024/11/27/2024-27410/organ-procurement-and-transplantation-implementation-of-the-hiv-organ-policy-equity-hope-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-27410.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27410.pdf?1732628714","publication_date":"2024-11-27","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":"non-liver HOPE Act <span class=\"match\">transplants</span>. Since 2019, when the OPTN's HOPE Act policy was expanded to include all solid <span class=\"match\">organs</span>, only three heart <span class=\"match\">transplant</span> <span class=\"match\">programs</span> have received approval to perform HOPE Act <span class=\"match\">transplants</span>. To date, just three heart <span class=\"match\">transplants</span> have been conducted, including one heart-kidney <span class=\"match\">transplant</span>.\n 21 22 \n \n No HOPE Act <span class=\"match\">transplants</span> have been recorded among recipients in need of other <span class=\"match\">organs</span>. The lack of data makes it difficult to assess the safety and outcomes of HOPE Act <span class=\"match\">transplants</span> other than kidney and liver HOPE Act <span class=\"match\">transplants</span>.\n \n \n \n 21"},{"title":"Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model","type":"Rule","abstract":"This final rule describes a new mandatory alternative payment model, the Increasing Organ Transplant Access Model (IOTA Model), that will test whether performance-based upside risk payments or downside risk payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end- stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This final rule also adopts standard provisions that will apply to the Radiation Oncology Model, the End-Stage Renal Disease (ESRD) Treatment Choices Model, and mandatory Innovation Center models, including the IOTA Model, whose first performance period begins on or after January 1, 2025. The finalized standard provisions relate to beneficiary protections; cooperation in model evaluation and monitoring; audits and records retention; rights in data and intellectual property; monitoring and compliance; remedial action; model termination by CMS; limitations on review; miscellaneous provisions on bankruptcy and other notifications; and the reconsideration review process.","document_number":"2024-27841","html_url":"https://www.federalregister.gov/documents/2024/12/04/2024-27841/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-04/pdf/2024-27841.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27841.pdf?1732655723","publication_date":"2024-12-04","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"}],"excerpts":"to as the <span class=\"match\">transplant</span> ecosystem) that comprises a vast network of institutions dedicated to ensuring that patients are evaluated and, if appropriate, placed onto the <span class=\"match\">organ</span> <span class=\"match\">transplant</span> waitlist, and that those on the <span class=\"match\">organ</span> <span class=\"match\">transplant</span> waitlist receive lifesaving <span class=\"match\">organ</span> <span class=\"match\">transplants</span>. <span class=\"match\">Transplantation</span> of livers, hearts, lungs, and other <span class=\"match\">organs</span> is also well established within the U.S. health care system. The <span class=\"match\">transplant</span> ecosystem includes the <span class=\"match\">Organ</span> Procurement and <span class=\"match\">Transplantation</span> Network (OPTN); <span class=\"match\">Organ</span> Procurement <span class=\"match\">Organizations</span> (OPOs); <span class=\"match\">transplant</span> hospitals"},{"title":"Organ Procurement and Transplantation: Implementation of the HIV Organ Policy Equity (HOPE) Act","type":"Proposed Rule","abstract":"The Department of Health and Human Services (HHS) proposes to amend the regulations implementing the National Organ Transplant Act of 1984, as amended (NOTA), to remove clinical research and institutional review board (IRB) requirements (\"research and IRB requirements\") for transplantation of kidney and livers from donors with human immunodeficiency virus (HIV) to recipients with HIV. As allowed by the HIV Organ Policy Equity (HOPE) Act, the Secretary of HHS proposes to determine that participation in such clinical research should no longer be a requirement for transplantation of HIV positive kidneys and livers from donors with HIV to recipients with HIV. This proposed rule serves as publication of the Secretary's proposed determination and proposes to amend the regulations to reflect this determination. Consistent with NOTA and current regulatory requirements, the Secretary's proposed determination and the proposed corresponding regulatory revision, if finalized, will necessitate that the Organ Procurement and Transplantation Network (OPTN) adopt and use standards of quality concerning kidneys and livers from donors with HIV, as directed by the Secretary, consistent with NOTA and in a way that ensures the revised requirements for transplantation of such organs will not reduce the safety of organ transplantation.","document_number":"2024-20643","html_url":"https://www.federalregister.gov/documents/2024/09/12/2024-20643/organ-procurement-and-transplantation-implementation-of-the-hiv-organ-policy-equity-hope-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-12/pdf/2024-20643.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-20643.pdf?1726058732","publication_date":"2024-09-12","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":"permit <span class=\"match\">transplants</span> of <span class=\"match\">organs</span> from donors with HIV in accordance with the HOPE Act requirements.\n \n \n \n 4 \n  \n Federal Register \n . <span class=\"match\">Organ</span> Procurement and <span class=\"match\">Transplantation</span>: Implementation of the HIV <span class=\"match\">Organ</span> Policy Equity (HOPE) Act. 2015 May:80 FR 26464. \n https://www.federalregister.gov/documents/2015/05/08/2015-11048/<span class=\"match\">organ</span>-procurement-and-<span class=\"match\">transplantation</span>-implementation-of-the-hiv-<span class=\"match\">organ</span>-policy-equity-act. \n \n \n \n The HOPE Act also directs the Secretary to develop and publish criteria for the conduct of research relating to <span class=\"match\">transplantation</span> of <span class=\"match\">organs</span> from"},{"title":"Medicare Program; Strengthening Oversight of Accrediting Organizations (AOs) and Preventing AO Conflicts of Interest, and Related Provisions","type":"Rule","abstract":"This final rule with comment period sets forth provisions to strengthen the oversight of Medicare national accrediting organizations by addressing conflicts of interest, establishing consistent standards, processes, and definitions, and updating the validation and performance standards systems. Additionally, this final rule with comment period revises the psychiatric hospital survey process, adds a limitation on terminated deemed providers and suppliers when reentering the program, and provides technical corrections for End-Stage Renal Disease facilities and Transplant Programs.","document_number":"2026-12069","html_url":"https://www.federalregister.gov/documents/2026/06/16/2026-12069/medicare-program-strengthening-oversight-of-accrediting-organizations-aos-and-preventing-ao","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-16/pdf/2026-12069.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-12069.pdf?1781295308","publication_date":"2026-06-16","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":"other CMS <span class=\"match\">programs</span> have established similar conflict-of-interest and independence provisions for <span class=\"match\">organizations</span> that have a public trust role in assessing the quality of services provided. For example, in the Medicaid <span class=\"match\">program</span>, CMS has established regulatory standards with respect to the independent judgment of any External Quality Review <span class=\"match\">Organization</span> that reviews the quality of the Medicaid managed care <span class=\"match\">organization</span> for the State (42 CFR 438.354). These regulations establish, among other requirements, that an External Quality Review <span class=\"match\">Organization</span> may not"},{"title":"Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model","type":"Proposed Rule","abstract":"This proposed rule describes a new mandatory Medicare payment model, the Increasing Organ Transplant Access Model (IOTA Model), that would test whether performance-based incentive payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This proposed rule also includes standard provisions that would apply to Innovation Center models whose first performance period begins on or after January 1, 2025, and also would apply, in whole or part, to any Innovation Center model whose first performance period begins prior to January 1, 2025 should such model's governing documentation incorporate the provisions by reference in whole or in part. The proposed standard provisions relate to beneficiary protections; cooperation in model evaluation and monitoring; audits and records retention; rights in data and intellectual property; monitoring and compliance; remedial action; model termination by CMS; limitations on review; miscellaneous provisions on bankruptcy and other notifications; and the reconsideration review process.","document_number":"2024-09989","html_url":"https://www.federalregister.gov/documents/2024/05/17/2024-09989/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-17/pdf/2024-09989.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-09989.pdf?1715199328","publication_date":"2024-05-17","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"}],"excerpts":"<span class=\"match\">organ</span>-specific <span class=\"match\">transplant</span> <span class=\"match\">program</span> within a <span class=\"match\">transplant</span> hospital,” as so defined. In accordance with 42 CFR 482.98, a <span class=\"match\">transplant</span> <span class=\"match\">program</span> must have a primary <span class=\"match\">transplant</span> surgeon and a <span class=\"match\">transplant</span> physician with the appropriate training and experience to provide <span class=\"match\">transplantation</span> services, who are immediately available to provide <span class=\"match\">transplantation</span> services when an <span class=\"match\">organ</span> is offered for <span class=\"match\">transplantation</span>. The <span class=\"match\">transplant</span> surgeon is responsible for providing surgical services related to <span class=\"match\">transplantation</span>, and the transplant physician is responsible for providing"},{"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":"coalition of dialysis <span class=\"match\">organizations</span>, a non-profit dialysis association, large dialysis <span class=\"match\">organizations</span> (LDOs), a small dialysis <span class=\"match\">organization</span> within a large non-profit health system, a professional association, a non-profit kidney care alliance, a national <span class=\"match\">organization</span> of patients and kidney health care professionals, a non-profit kidney <span class=\"match\">organization</span>, a network of dialysis <span class=\"match\">organizations</span> and regional offices, a provider advocacy <span class=\"match\">organization</span>, a non-profit <span class=\"match\">organization</span> of ESRD networks, a non-profit health insurance <span class=\"match\">organization</span> in Puerto Rico, a non-profit"},{"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":"1881(b)(14) of the Act to individuals with AKI at the ESRD PPS base rate beginning January 1, 2017. This proposed rule proposes to update the AKI dialysis payment rate for CY 2026. \n 3. <span class=\"match\">End-Stage</span> Renal Disease Quality Incentive <span class=\"match\">Program</span> (ESRD QIP) \n The <span class=\"match\">End-Stage</span> Renal Disease Quality Incentive <span class=\"match\">Program</span> (ESRD QIP) is authorized by section 1881(h) of the Act. The <span class=\"match\">Program</span> establishes incentives for facilities to achieve high quality performance on measures with the goal of improving outcomes for ESRD beneficiaries. Beginning with PY 2027, this proposed"},{"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":"the choice is between solid-<span class=\"match\">organ</span> pancreas <span class=\"match\">transplantation</span> alone or islet <span class=\"match\">transplantation</span>.\n 14 \n \n Islet cell <span class=\"match\">transplantation</span> offers a less invasive established alternative to pancreas <span class=\"match\">transplant</span>, and the procedures are regulated similarly.\n 15 \n \n The goal of both pancreas whole <span class=\"match\">organ</span> <span class=\"match\">transplant</span> and islet cell <span class=\"match\">transplantation</span> is to enable effective, stable glycemic management (often with insulin independence), to improve quality of life, and to reduce secondary complications. Both pancreas and islet cell <span class=\"match\">transplantation</span> require lifelong immunosuppression"},{"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":"exempted from the 340B payment adjustment would report modifier “JG” (Drug or biological acquired with 340B Drug Pricing <span class=\"match\">Program</span> Discount) to identify if a drug was acquired under the 340B <span class=\"match\">Program</span>. The phrase “acquired under the 340B <span class=\"match\">Program</span>” would include all drugs acquired under the 340B <span class=\"match\">Program</span> or Prime Vendor <span class=\"match\">Program</span>, regardless of the level of discount applied to the drug. Drugs that were not acquired under the 340B <span class=\"match\">Program</span> would not be reported with the modifier “JG”. For separately payable drugs (status indicator “K”), application of modifier"},{"title":"Medicare and Medicaid Programs; CY 2026 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","type":"Rule","abstract":"This major final rule addresses: changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; codification of establishment of new policies for: the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; the Ambulatory Specialty Model; updates to the Medicare Diabetes Prevention Program expanded model; updates to drugs and biological products paid under Part B; Medicare Shared Savings Program requirements; updates to the Quality Payment Program; updates to policies for Rural Health Clinics and Federally Qualified Health Centers; update to the Ambulance Fee Schedule regulations; codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2023 provisions; updates to the Medicare Promoting Interoperability Program.","document_number":"2025-19787","html_url":"https://www.federalregister.gov/documents/2025/11/05/2025-19787/medicare-and-medicaid-programs-cy-2026-payment-policies-under-the-physician-fee-schedule-and-other","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-11-05/pdf/2025-19787.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-19787.pdf?1761945018","publication_date":"2025-11-05","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":"rebatable drug for which a manufacturer provides a discount under the 340B <span class=\"match\">Program</span> for the applicable period beginning October 1, 2025, as well as the establishment of a voluntary 340B data repository for Part D claims for testing purposes. \n This final rule modifies policies for the Shared Savings <span class=\"match\">Program</span>, which is a voluntary <span class=\"match\">program</span> that started in 2012. The <span class=\"match\">program</span> allows healthcare providers to form or participate in Accountable Care <span class=\"match\">Organizations</span> (ACOs), to be held accountable for the quality and total cost of care for an assigned population"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 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":"2025-06271","html_url":"https://www.federalregister.gov/documents/2025/04/30/2025-06271/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06271.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06271.pdf?1744402510","publication_date":"2025-04-30","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":"Hospital Readmission Reduction <span class=\"match\">Program</span> \n We estimated that our changes for the Hospital Readmissions Reduction <span class=\"match\">Program</span> will result in no financial impact for the FY 2027 payment determination or subsequent years. \n \n \n Changes to the Value-Based Incentive Payments under the Hospital VBP <span class=\"match\">Program</span> \n We estimated that there will be no net financial impact to the Hospital VBP <span class=\"match\">Program</span> for the FY 2026 <span class=\"match\">program</span> year in the aggregate because, by law, the amount available for value-based incentive payments under the <span class=\"match\">program</span> in a given year must be equal to"},{"title":"Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments","type":"Rule","abstract":"This final rule addresses: changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; codification of establishment of new policies for, the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; updates to the Medicare Diabetes Prevention Program expanded model; payment for dental services inextricably linked to specific covered medical services; updates to drugs and biological products paid under Part B including immunosuppressive drugs and clotting factors; Medicare Shared Savings Program requirements; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; updates to policies for Rural Health Clinics and Federally Qualified Health Centers; electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan or a Medicare Advantage Prescription Drug (MA-PD) plan under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act); update to the Ambulance Fee Schedule regulations; codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2023 provisions; updates to Clinical Laboratory Fee Schedule regulations; updates to the diabetes payment structure and PHE flexibilities; expansion of colorectal cancer screening and Hepatitis B vaccine coverage and payment; establishing payment for drugs covered as additional preventive services; Medicare Parts A and B Overpayment Provisions of the Affordable Care Act and Medicare Parts C and D Overpayment Provisions of the Affordable Care Act.","document_number":"2024-25382","html_url":"https://www.federalregister.gov/documents/2024/12/09/2024-25382/medicare-and-medicaid-programs-cy-2025-payment-policies-under-the-physician-fee-schedule-and-other","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-09/pdf/2024-25382.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25382.pdf?1730492138","publication_date":"2024-12-09","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":"substantially related and integral to the clinical success of, the <span class=\"match\">organ</span> <span class=\"match\">transplant</span> procedure (87 FR 69676). \n \n Furthermore, we stated that we appreciated commenters' feedback regarding those individuals who are awaiting <span class=\"match\">organ</span> <span class=\"match\">transplantation</span> and the commenters' request that Medicare provide payment for medically necessary dental services prior to <span class=\"match\">transplantation</span>. We described that in a case where an individual is awaiting <span class=\"match\">organ</span> <span class=\"match\">transplantation</span>, we believe that it is appropriate for Medicare to provide payment for, including but not limited to, an oral or"},{"title":"Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots","type":"Rule","abstract":"This final rule with comment period revises 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. In addition, this final rule with comment period announces the closure of a teaching hospital and the opportunity to apply for available slots, and updates and refines 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, as well as summarizes comments received in response to a request for information on measure concepts regarding Well-Being and Nutrition for consideration in future years for the OQR, REHQR, and ASCQR programs.","document_number":"2025-20907","html_url":"https://www.federalregister.gov/documents/2025/11/25/2025-20907/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-11-25/pdf/2025-20907.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-20907.pdf?1763759710","publication_date":"2025-11-25","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"},{"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":"approach therefore functionally guts the 340B <span class=\"match\">Program's</span> benefits.”\n \n \n Response: \n We thank the commenter for their detailed comment outlining their concerns. We note that HRSA's 340B pilot <span class=\"match\">program</span> is out of scope for purposes of this rulemaking and CMS defers to HRSA for specifics on this <span class=\"match\">program</span>. This pilot <span class=\"match\">program</span> has yet to go into effect, and the period of the survey does not overlap with the pilot <span class=\"match\">program</span>, but we can consider how to incorporate any potential intersection between that <span class=\"match\">program</span> and Medicare payment policy in future rulemaking"},{"title":"Medicare and Medicaid Programs; CY 2026 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","type":"Proposed Rule","abstract":"This major proposed rule addresses: changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; codification of establishment of new policies for: the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; the Ambulatory Specialty Model; updates to the Medicare Diabetes Prevention Program expanded model; updates to drugs and biological products paid under Part B; Medicare Shared Savings Program requirements; updates to the Quality Payment Program; updates to policies for Rural Health Clinics and Federally Qualified Health Centers update to the Ambulance Fee Schedule regulations; codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2023 provisions; updates to the Medicare Promoting Interoperability Program.","document_number":"2025-13271","html_url":"https://www.federalregister.gov/documents/2025/07/16/2025-13271/medicare-and-medicaid-programs-cy-2026-payment-policies-under-the-physician-fee-schedule-and-other","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-16/pdf/2025-13271.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-13271.pdf?1752524111","publication_date":"2025-07-16","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 using the same exchange function from other CMS <span class=\"match\">programs</span> would help stakeholders that use these <span class=\"match\">programs</span>' payment information across care settings better understand ASM's payment methodology. Both the Hospital VBP <span class=\"match\">program</span> and the Quality Payment \n \n <span class=\"match\">Program</span> use some form of a linear exchange function in their payment methodologies. Three key <span class=\"match\">program</span> aspects that facilitate the use of a linear exchange function are a <span class=\"match\">program's</span> number of measures, measure weights, and correlation across <span class=\"match\">program</span> measures. These three aspects mean that there is less"},{"title":"DoNation Campaign Collaboration Projects","type":"Notice","abstract":"HRSA's Health Systems Bureau (HSB), Division of Transplantation (DoT) solicits requests from non-federal public and private sector organizations and entities who wish to collaborate on the DoNation Campaign. DoNation collaboration projects will involve executing a series of activities that elevate the benefits and importance of organ, eye, and tissue donation and increase organ donor registrations among the public with a focus on individuals from diverse racial and ethnic backgrounds. Potential collaborating organizations must have demonstrated interest in and experience with coordinating activities that address key public health issues, be capable of managing the day-to-day operations associated with the proposed activity(ies), and be willing to participate substantively in the execution of the proposed activity(ies), not just providing funding or logistical support.","document_number":"2023-00063","html_url":"https://www.federalregister.gov/documents/2023/01/06/2023-00063/donation-campaign-collaboration-projects","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-01-06/pdf/2023-00063.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-00063.pdf?1672926327","publication_date":"2023-01-06","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":"Health Resources and Services Administration","name":"Health Resources and Services Administration","id":222,"url":"https://www.federalregister.gov/agencies/health-resources-and-services-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/222","parent_id":221,"slug":"health-resources-and-services-administration"}],"excerpts":"SUPPLEMENTARY INFORMATION: \n Background \n The Division of <span class=\"match\">Transplantation</span> (DOT), within HRSA's Heath Systems Bureau, is the primary federal entity responsible for oversight of the nation's <span class=\"match\">organ</span> and blood stem cell <span class=\"match\">transplant</span> systems and the implementation of <span class=\"match\">programs</span> and initiatives that increase <span class=\"match\">organ</span> and blood stem cell donations in the United States. DoT's mission is to protect public health and extend and enhance the lives of individuals with <span class=\"match\">end-stage</span> <span class=\"match\">organ</span> failure for whom an <span class=\"match\">organ</span> <span class=\"match\">transplant</span> is the most appropriate therapeutic treatment. DoT,"},{"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":"Infection (HAI) measures beginning with the FY 2029 <span class=\"match\">program</span> year, and the technical update to the six measures in the Clinical Outcomes domain beginning with the FY 2027 <span class=\"match\">program</span> year. We are finalizing removal of the Health Equity Adjustment (HEA) from the <span class=\"match\">program's</span> scoring calculations in the FY 2026 <span class=\"match\">program</span> year. We provide previously and newly established performance standards for FY 2027 through FY 2031 <span class=\"match\">program</span> years for the Hospital VBP <span class=\"match\">Program</span>. \n In the Hospital-Acquired Condition (HAC) Reduction <span class=\"match\">Program</span>, we are also providing notice of the technical"},{"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":"REHQR, and ASCQR <span class=\"match\">Programs</span> \n XV. Hospital Outpatient Quality Reporting (OQR) <span class=\"match\">Program</span> \n A. Background and History of the Hospital OQR <span class=\"match\">Program</span> \n B. Proposed Changes to the Hospital OQR <span class=\"match\">Program</span> Measure Set \n C. Proposed Updates to the Form, Manner, and Timing of Hospital OQR <span class=\"match\">Program</span> Data Submission \n D. Payment Reduction for Hospitals That Fail To Meet the Hospital OQR <span class=\"match\">Program</span> Requirements for the CY 2026 Payment Determination \n XVI. Rural Emergency Hospital Quality Reporting (REHQR) <span class=\"match\">Program</span> \n A. Background and History of the REHQR <span class=\"match\">Program</span> \n B. Proposed"}]}