CMS Finalizes IPPS for 2025, Excludes Blood From Essential Medicines List

The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule on Aug. 1. The final rule is scheduled for publication in the Federal Register on Aug. 28.

The final rule increases operating payment rates by 2.9% for general acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) program and are meaningful electronic health record users. 

CMS also finalized a separate payment under the IPPS for small, independent hospitals to establish and maintain a buffer stock of essential medicines as a preventive measure to guard against future shortages. Notably, the agency elected to use a list of essential medicines developed by the Advanced Regenerative Manufacturing Institute (ARMI), which excludes blood and blood products. The blood community previously urged CMS to use the Food and Drug Administration’s Executive Order 13944, which includes blood and blood products.

In response to comments from the blood community, CMS stated that its policy is “not intended to include medicines that would be used for longer-term chronic management, including those needed to cure a condition through weeks or months of outpatient treatment in the outpatient setting or chronic care.”

A fact sheet for the final rule is available online.