On April 10, 2023, CMS issued proposed changes to Medicare’s inpatient prospective payments made to acute care and long-term care hospitals. Specifically, CMS proposes a 2.8% increase to hospitals that successfully participate in the Inpatient Quality Reporting program and are meaningful electronic health record (EHR) users. They also propose to continue policies that support low-wage index hospitals, many of which are rural, and to include data for hospitals that reclassify from urban to rural (42 CFR §412.103) in other wage index calculations. There is a proposal to adjust payments when homelessness is indicated and a Request for Information on the unique challenges faced by safety-net hospitals and the patients they serve. Finally, CMS has proposed to allow Rural Emergency Hospitals (REH), a Medicare new provider type, to serve as training sites for Medicare Graduate Medical Education (GME) payment purposes, and they provided proposed regulations on what information must be submitted to CMS when a hospital applies to become an REH. Comments are due by June 9, 2023.