(April 7, 2026) - This past week, the Centers for Medicare & Medicaid Services released several proposed rules affecting hospitals and other health care facilities for the fiscal year 2027. They finalized other rules governing Medicare Advantage plans for the upcoming year.
CMS has finalized rules for Medicare Advantage and Part D rates for calendar year 2027. The rate announcement finalized a net average year-over-year increase of 2.48 percent in MA plan payments, or over $13 billion more than in 2026. This is an increase over the agency’s estimate of 0.09 percent, or $700 million more than in 2026, which was proposed earlier this year. Additionally, MA plans will no longer be mandated to send midyear notices about unused supplemental benefits, and CMS is removing various MA Star Rating measures related to appeals and provider complaints, despite significant public feedback opposing their removal.
Regarding health care facilities, CMS has released proposed rules for skilled nursing, inpatient rehabilitation and inpatient psychiatric facilities. Key highlights include:
- 2.4 percent increase in payments to SNFs.
- 2.8 percent increase in payments to IRFs.
- 2.3 percent payment increase for IPFs.
- A SNF request for information on how to address perceived case-mix upcoding.
- A proposal that IRFs must initiate all therapies within 36 hours of admission.
- An IRF request for information on modernizing the IRF prospective payment system, including more closely aligning methodologies with those used for skilled nursing facilities.
- A proposal to remove two measures focused on COVID-19 vaccination for patients and health care personnel.
- A proposal to shorten the timeframe for data submission at the end of each quarter from 4.5 months to 45 days, beginning with FY 2029.
CMS is accepting public comments on these proposals through June 1, 2026. If you have feedback, please reach out to Jaron Caffrey by May 8 to help in drafting the Kansas Hospital Association’s comments. CMS is expected to soon release the proposed rule for the 2027 Inpatient Prospective Payment System.