Key CMS OPPS 2026 Final Rule Updates Hospitals Should Know
What’s happening
On November 21st, the Centers for Medicare & Medicaid Services (CMS) finalized payment rate and policy updates within the Medicare hospital outpatient prospective payment system (OPPS) for calendar year (CY) 2026.
Of interest
For CY 2026, CMS is implementing changes to the following policies important to hospitals:
Notably, CMS declined to finalize its proposal to increase the 340B program recoupment adjustment under the OPPS. However, CMS signaled it may revisit this decision in CY 2027.
These are just some of the more notable changes. CMS finalized dozens of policy changes relevant to hospitals. Our partners at McDermott+, one of healthcare’s most trusted and respected policy and lobbying consulting firms, wrote a summary of the final rule
Why you should care
CMS’s decisions will impact 340B programs, hospital payment rates, physician practice acquisition strategies, the range of services furnished in ASCs and ASC collaboration strategies, the Rural Emergency Hospital Quality Reporting Program reporting requirements, and more. Hospital leaders should be informed about these policy changes and their implications.
Looking to learn more?
McDermott+ offers valuable insights into what these policy updates mean and how they could affect organizations. Read more to see what McDermott+ is saying about these policies and how your organization could be impacted.
Click here for the OPPS final rule analysis.