Key Takeaways CMS finalized the FY 2027 IPPS rule on July 31, 2026, setting a 2.3% payment rate increase for hospitals that meet quality reporting and EHR requirements CJR-X — a nationwide, mandatory expansion of the Comprehensive Care for Joint Replacement model — starts January 1, 2028, and will apply to nearly every acute care hospital performing hip, knee, or ankle replacements CJR-X carries two-sided financial risk: hospitals can earn reconciliation payments or owe CMS a

Most hospital revenue cycle leaders know exactly what a transfer DRG overpayment looks like. It looks like an OIG audit. It looks like a takeback. It looks like a recoupment letter from the MAC. CMS has built decades of edits, audits, and oversight processes designed to catch hospitals that miscode a transfer as a routine discharge and collect a full MS-DRG payment they weren't entitled to. Here's what most teams don't see as clearly: the policy is asymmetric. CMS has edits t