Traditional MedicareReimbursementMedium impact
2026-04-13 - Hospital Inpatient Prospective Payment System & Long-Term Care Hospital Prospective Payment System Proposed Rule: FY 2027
Medicare/CMS·Payment
Effective date
Oct 1, 2026
We identified it
Apr 14, 2026
Summary
CMS proposed a 2.4% increase in Medicare inpatient hospital payment rates for FY 2027, effective October 1, 2026. The rule also proposes new prior authorization timelines for drugs: 24 hours for urgent requests and 72 hours for standard requests, with increased transparency requirements for claim denials.
Action Required
By October 1, 2026: Billing team should prepare for updated Medicare inpatient payment rates (2.4% increase). Monitor for final rule publication to confirm exact rate changes. For practices that prescribe drugs requiring prior authorization, prepare systems to track new timeline requirements (24 hours urgent, 72 hours standard) once finalized.