The Proposed Rule for the Outpatient Prospective Payment System went on public display July 2nd and was published July 7, 2026 and features:
- A new 340B drug payment methodology based on acquisition cost survey data
- A substantially larger 340B remedy offset (3%)
- Continued migration of procedures out of the inpatient setting
- Expanded prior authorization
- Increased scrutiny of off-campus provider-based departments
- A renewed push toward standardized hospital price transparency
Hospitals should model the proposal now to seek a competitive advantage.
Quick Highlights:
- +2.4% OPPS payment and ASC payment update for outpatient departments
- ASP minus 33.4% proposed payment rate for 340B-acquired drugs
- 340B remedy offset increases from 0.5% to 3.0% for applicable hospitals
- Estimated 8.44% increase in non-drug OPPS payments for budget neutrality
- 637 procedures proposed for removal from the Inpatient Only (IPO) List
- No proposed changes to the Rural Emergency Hospital Quality Reporting Program
- New payment proposal affecting certain imaging services furnished in excepted off-campus provider-based departments
Comments are due by August 31, 2026 and the Proposed Rule can be found by
clicking here.