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Proposed Changes to the MS-LTC-DRGs for FY 2024 As specified by our regulations at 412.517(a), which require that the MS-LTC-DRG classifications and relative weights be updated annually, and consistent with our historical practice of using the same patient classification system under the LTCH PPS as is used under the IPPS, in this proposed rule, we are proposing to update the MS-LTC-DRG classifications effective October 1, 2023 through September 30, 2024 (FY 2024) consistent with the proposed changes to specific MS-DRG classifications presented in section II.F

Given the fairly short half-life of unbound IGF-1 in serum (i.e., 510 min), binding to an IGF binding protein (IGFBP-3 is the most prevalent) in serum or in ECM increases IGF-1 half-life to around 25 min (Allard and Duan, 2019), leading to the production of phosphatidylinositol 3,4,5-trisphosphate (PIP3) (O'Neill et al., 2015)

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