The Centers for Medicare & Medicaid Services (CMS) has issued a final rule titled “Fiscal Year (FY) 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS).” The 2025 CMS IPPS rule does not include blood or blood products in the list of essential medicines. America’s Blood Centers, the Association for the Advancement of Blood & Biotherapies, and the American Red Cross previously requested in joint comments that listing include blood and blood products to, “ensure that the payments are sufficient to cover all costs associated with procuring and maintaining essential medicines, including a ‘buffer stock’ of blood and blood products.”
The agency responded to comments in 2025 CMS IPPS rule by explaining that, “[w]e appreciate the commenters’ feedback and diverse clinical perspectives on defining an appropriate and effective list of essential medicines. As we discussed in the proposed rule, the Advanced Regenerative Manufacturing Institute (ARMI) List is a prioritized subset of 86 essential medicines from the Executive Order 13944 List that are either critical for minimum patient care in acute settings or important for acute care with no comparable alternatives available. The medicines included in the ARMI List were considered, by consensus, to be most critically needed for typical acute patient care. In this context, acute patient care was defined as: rescue use or lifesaving use or both (that is, Intensive Care Units, Cardiac/Coronary Care Units, and Emergency Departments), stabilizing patients in hospital continued care to enable discharge, and urgent or emergency surgery. Development of the ARMI List focused on assessing the clinical criticality and supply chains of small molecules and therapeutic biologics…[W]hile the EO 13944 List includes blood and blood products, this 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. Based on the comprehensive assessment and process followed to develop the ARMI List, as well as the inclusion of a variety of inputs and perspectives across the pharmaceutical supply chains—from industry to clinical community and the public at large — we believe that use of the ARMI List to identify essential medicines for purposes of this policy is appropriate to promote supply chain resilience at this juncture. After consideration of the comments received, we are finalizing as proposed our use of the ARMI List.”
Additionally, the 2025 CMS IPPS final rule includes an, “increase in operating payment rates 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 (EHR) users is 2.9 percent. This reflects a projected FY 2025 hospital market basket percentage increase of 3.4 percent, reduced by a 0.5 percentage point productivity adjustment.”
The final rule will be published in the Federal Register on August 28th.