News: CMS issues final rule making changes to the Increasing Organ Transplant Access Model

CMS finalized changes to the Increasing Organ Transplant Access (IOTA) Model beginning July 1. IOTA is a six-year mandatory model for certain kidney transplant hospitals that began July 1, 2025.

CMS finalized its proposal to raise the low-volume threshold from 11 kidney transplants performed annually during each of the baseline years to 15. The agency also finalized its proposal to include Medicare Advantage beneficiaries in the calculation of upside and downside risk payments.

Although CMS considered lowering the maximum upside risk payment to $10,000 per transplant, it will remain $15,000 due to comments in opposition from the American Hospital Association (AHA) and other stakeholders.

CMS also adopted requirements for notifying patients of changes in waitlist status. However, in response to many concerns raised by the AHA and other commentators, it did not finalize its proposals regarding notifications of declined organ offers.

In a modification of its original proposal, the finalized rule included an updated risk adjustment methodology for performance on the model’s one quality measure that is consistent with the widely used Scientific Registry of Transplant Recipients framework.

Editor’s note: To read the full rule, click here. To read additional coverage from the AHA, click here.