Comment by May 28. CMS released proposed rules for Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), and Hospice Wage Index and Payment Rate updates. Each rule proposes updates to Medicare payment and quality measurement policies for Fiscal Year 2025, which begins October 1. The proposed rules indicate a 4.9 percent increase in payments for rural SNFs, a 4.6 percent increase for rural IRFs, and a 2.8 percent increase in payments for rural hospices.