The Centers for Medicare & Medicaid Services (CMS) has released its proposed inpatient prospective payment system (IPPS) rule for fiscal year 2023, with changes that would impact reporting used to calculate Medicare disproportionate share hospital (DSH) payments, limit the types of Medicaid section 1115 waiver days that can be included for purposes of the Medicare DSH formula, and establish a new hospital quality designation related to maternal care, among other proposals. CMS also asks for comments related to a number of areas, including principles for measuring health equity and disparities, codes used to collect data on social determinants of health, and the effects of climate change on health.