Public Inspection: CMS: Medicare Program: Alternative Payment Model Updates and the Increasing Organ Transplant Access Model

Federal Register

May 29, 2026

Pre-publication notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) updating and revising the Increasing Organ Transplant Access Model (IOTA Model) for Performance Year (PY) 2. The IOTA Model tests whether performance-based upside risk payments or downside risk payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This rule is effective 30 days after the publication of this notice, which is scheduled for June 1, 2026.

Access · Funding · Hospitals · Legislation and regulations · Medicare · Reimbursement and payment models · Service delivery models · Specialty care