Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model (CMS-5544-P)

This proposed rule would update and revise the Increasing Organ Transplant Access (IOTA) Model for Performance Year (PY) 2. It would modify participant eligibility by raising the minimum annual kidney transplant threshold from 11 to 15 and excluding VA and military medical facilities, aligning participation with Medicare-paid hospitals. The rule adds risk adjustment and excludes multi-organ transplants in performance scoring, adjusts payment timing and emergency flexibilities, and refines transparency and beneficiary notification requirements. It also removes health equity plan provisions and strengthens monitoring and termination criteria to improve access, quality, and program integrity under the IOTA Model.