Federal Register #2026-10890

CMS Final Rule: Updates to Medicare IOTA Model for Kidney Transplant Hospitals

This final rule from the Centers for Medicare & Medicaid Services (CMS) updates the Increasing Organ Transplant Access (IOTA) Model, a mandatory 6-year Medicare payment program for kidney transplant hospitals. - Government Buyer: - Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), CMS Innovation Center - Products/Services Requested: - No commercial products or services are being procured; this is a regulatory update affecting hospital participation in a payment model - The model covers kidney transplant procedures for Medicare fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries - Key Requirements and Notable Details: - Raises the minimum annual kidney transplant threshold for hospital eligibility from 11 to 15 - Excludes Department of Veterans Affairs (VA) medical facilities and military medical treatment facilities from participation - Incorporates Medicare Advantage beneficiaries in payment calculations - Uses a risk-adjusted composite graft survival rate based on Scientific Registry of Transplant Recipients (SRTR) methodology - Requires public posting of patient selection and living donor criteria - Mandates notifications to Medicare waitlist patients about status changes - Maximum upside risk payment is $15,000 per transplant; downside risk payments begin in Performance Year 2 - Emphasizes patient engagement, monitoring, and compliance - Removes voluntary health equity plan provisions to reduce administrative burden - No OEMs or commercial vendors are mentioned, as this is not a procurement of goods or services

Description

This final rule updates and revises the Increasing Organ Transplant Access (IOTA) Model for Performance Year 2, including a technical correction to the regulatory text. The IOTA Model is a 6-year mandatory alternative payment model aimed at kidney transplant hospitals to increase the number of kidney transplants, improve quality, and enhance patient experience. Key updates include raising the low volume threshold for eligibility from 11 to 15 kidney transplants annually, modifications to performance assessment metrics, and adjustments to payment methodologies. The regulation is effective July 1, 2026.

View original listing