Documents › Agency rules › 2026-10890
Health and Human Services Department, Centers for Medicare & Medicaid Services
Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
Published June 1, 2026. Takes effect July 1, 2026, printed at 91 FR 32788, amending 42 CFR 512. 74,048 words.
A Medicare test program is being updated. It deals with getting an organ.
What the Rule Says It Does
This final rule will update and revise the Increasing Organ Transplant Access (IOTA) Model for Performance Year (PY) 2. This final rule also includes a technical correction to the regulatory text.
This is the rule's own summary, as the Federal Register prints it.
The Order It Names
The rule names this order itself. What it does about it is a reading, and none is recorded here.
On the Face of the Rule
- As filed
[Federal Register Volume 91, Number 104 (Monday, June 1, 2026)] [Rules and Regulations] [Pages 32788-32873] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 2026-10890]
Vol. 91
Monday,
No. 104
June 1, 2026
Part IV
Department of Health and Human Services
Centers for Medicare & Medicaid Services
42 CFR Part 512
Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model; Final Rule
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 512
[CMS-5544-F] RIN 0938-AV65
Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
- AGENCY
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS).
- ACTION
Final rule.
- DATES
These regulations are effective on July 1, 2026.
- FOR FURTHER INFORMATION CONTACT
[email protected], for questions related to the Increasing Organ Transplant Access Model.
Thomas Duvall, (410) 786-8887, for questions related to the Increasing Organ Transplant Access Model.
Christina McCormick, (410) 786-4012, for questions related to the Increasing Organ Transplant Access Model.
The fields the Federal Register prints at the head of the rule, quoted as printed. Its summary is quoted above.
Why the Agency Says It Is Doing This
SUPPLEMENTARY INFORMATION
I. Background and Executive Summary
A. Model Overview and Background
The Increasing Organ Transplant Access (IOTA) Model is a 6-year mandatory alternative payment model tested by the CMS Innovation Center under section 1115A of the Social Security Act (the Act) that began on July 1, 2025, and will end on June 30, 2031. The model appeared in the December 4, 2024 Federal Register (89 FR 96280) titled “Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model” (hereinafter referred to as the 2024 Final Rule), and this final rule will update IOTA Model provisions in response to improvement opportunities that arose during implementation of the 2024 Final Rule and to better align the model with new administration priorities. The IOTA Model is aimed at kidney transplant hospitals with the goal of increasing the number of kidney transplants, improving quality, and improving patient experience during the transplant process.
The passage that opens the rule's preamble, where the agency sets out what it is doing and on what authority. Every heading that follows it is listed below.
What the Rule Contains
Every heading the Federal Register prints in this rule, in the order it prints them. 30 headings, 74,048 words in all.
- AGENCYOn its face · 15 words
- ACTIONOn its face · 3 words
- SUMMARYOn its face · 32 words
- DATESOn its face · 9 words
- FOR FURTHER INFORMATION CONTACTOn its face · 44 words
- SUPPLEMENTARY INFORMATIONPreamble · 2 words
- I. Background and Executive SummaryPreamble · 5 words
- A. Model Overview and BackgroundPreamble · 146 words
- B. Executive SummaryPreamble · 3 words
- 1. PurposePreamble · 3,400 words
- II. Changes to the Increasing Organ Transplant Access (IOTA) ModelPreamble · 10 words
- A. BackgroundPreamble · 2 words
- 1. PurposePreamble · 933 words
- B. Provisions of the Proposed RegulationPreamble · 60,854 words
- C. Request for Information (RFIs) on Topics Relevant to the IOTA ModelPreamble · 592 words
- III. Collection of Information RequirementsPreamble · 126 words
- IV. Regulatory Impact AnalysisPreamble · 4 words
- A. Statement of NeedPreamble · 130 words
- B. Overall ImpactPreamble · 349 words
- C. Detailed Economic AnalysisPreamble · 4 words
- 1. Policy Changes Modeled by RulePreamble · 344 words
- 2. Projected ImpactPreamble · 1,682 words
- 4. Estimated Burden on Kidney Transplant HospitalsPreamble · 607 words
- D. Regulatory Review Cost EstimationPreamble · 423 words
- E. Accounting Statement and TablePreamble · 143 words
- G. Regulatory Flexibility Act (RFA)Preamble · 814 words
- H. Unfunded Mandates Reform Act (UMRA)Preamble · 70 words
- I. FederalismPreamble · 65 words
- J. E.O. 14192, “Unleashing Prosperity Through Deregulation”Preamble · 111 words
- List of Subjects in 42 CFR part 512Regulatory text · 3,021 words
The Rest of the Text
This rule runs to 74,048 words. The rest of it is set out over 3 pages, split at the rule's own headings so that no heading is parted from the words printed under it.
- Text 1 of 3: B. Executive Summary to 1. Purpose5 headings · 4,348 words
- Text 2 of 3: B. Provisions of the Proposed Regulation1 heading · 60,854 words
- Text 3 of 3: C. Request for Information (RFIs) on Topics Relevant to the IOTA Model to List of Subjects in 42 CFR part 51216 headings · 8,485 words
- The rule itself
Health and Human Services Department, Centers for Medicare & Medicaid Services, “Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model,” 91 FR 32788 (June 1, 2026). Effective July 1, 2026.
https://www.federalregister.gov/documents/2026/06/01/2026-10890/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota - This page
“Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model,” a final rule naming an order indexed here. Read the Mandate, https://readthemandate.org/rules/rule-2026-10890/ (retrieved October 10, 2026).
Cite the document when the claim is about what the document says. Cite this page when the indexing, the wording or the record of what has happened is what is being relied on.
How This Rule Is Set Out
Federal Register documents are United States government works and are not under copyright, so the rule is here whole rather than cut to an excerpt. It is split at the headings the Register itself prints: the line it is filed under, the captioned fields on its face, the preamble where the agency says what it is doing and why, and the amendments to the Code of Federal Regulations. No passage is shortened. This rule is long enough that its text is set out over 3 pages rather than one.
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A heading with nothing quoted under it is one the rule prints on its own, with the words that follow it set under the headings beneath.