CMS Releases FY24 IPPS Proposed Updates and GME Changes

Published April 17, 2023

By AACOM Government Relations

Advocacy Federal Policy GME GME Funding OME Advocate

  • On April 10, 2023, the Centers for Medicare & Medicaid Services (CMS) unveiled its fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) proposed rule.
  • CMS proposes to treat Rural Emergency Hospitals (REHs) in a manner similar to Critical Access Hospitals (CAHs) for purposes of determining GME payments. This change should be favorable to rural communities and REHs as it would provide for continued training of residents in rural areas for converting CAHs and offer the opportunity for additional rural training of residents that might not otherwise be viable without the proposed new rules.
  • CMS also proposes to clarify Medicare cost report data used in calculating the indirect medical education resident-to-bed ratio when there is a change to a hospital’s full-time equivalent (FTE) residents due to participation in a GME affiliation agreement sharing FTE slots with another hospital.
  • By law, CMS must update its payment rates to IPPS hospitals every year and explain changes in the price of goods and services used by these hospitals. In FY24, CMS proposes a 2.8 percent rate increase for acute care hospitals, leading to a nearly $3.3 billion increase in payments.
  • Comments are accepted through 5:00 PM EDT on June 9, 2023. Please notify us at if you plan to submit comments to CMS.
  • For a more detailed analysis of the IPPS proposed rule, see AACOM’s summary.