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Association Comments on CY 2026 OPPS Proposed Rule

September 16, 2025
Evan Schweikert

In a Sept. 15 letter to the Centers for Medicare & Medicaid Services (CMS), America’s Essential Hospitals responded to the agency’s proposed annual update to the Outpatient Prospective Payment System (OPPS) and ambulatory surgical center payments. The association encouraged CMS to support essential hospitals through the creation of an essential hospital designation and additional adjustments to the proposed rule.

Specifically, the association urged the agency to:

  • Increase its proposed annual hospital payment update to match measured rates of inflation
  • Withdraw its proposal to cut payments for drug administration services in provider-based departments
  • Rescind its attempt to adjust the 340B Drug Pricing Program remedy recoupment methodology
  • Reconsider the necessity and timing of the proposed survey of hospital drug acquisition costs, and not use these conclusions to reduce OPPS payments for 340B hospitals
  • Withdraw proposed changes to hospital price transparency requirements
  • Incorporate suitable risk adjustment in new quality measures
  • Not finalize changes to the Overall Hospital Quality Star Rating

Contact Policy Analyst Evan Schweikert at eschweikert@essentialhospitals.org, or 202.585.0124 with questions.