CMS issued a proposed rule updating payment rates under the Medicare inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals in fiscal year 2015 (FY15). Some of the proposed changes implement certain statutory provisions contained in the Affordable Care Act (ACA), the Protecting Access to Medicare Act of 2014, and other legislation. These proposed changes would be applicable to discharges occurring on or after October 1, 2014. CMS also proposes to update the rate-of-increase limits, effective for cost reporting periods beginning on or after October 1, 2014, for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. CMS notes that while many of the statutory mandates of the Pathway for SGR Reform Act will apply to discharges occurring on or after October 1, 2014, others will not begin to apply until 2016 and beyond.