Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
Updated 9:24 AM MT
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Federal Policy·July 22, 2026

CMS Proposes CY 2027 Hospital Outpatient Payment and ASC Policy Changes

CMS issued the Calendar Year 2027 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center proposed rule affecting hospitals participating in Medicare. The proposed rule includes significant payment and policy changes for hospital outpatient services and ASCs. The rule establishes payment rates and updates operational policies for calendar year 2027. While focused on Medicare payment systems, managed care organizations contracting with hospitals for Medicaid services should monitor for potential cost-shifting effects and policy precedents that states may adopt.

Why it matters

Medicare OPPS rate changes often influence hospital cost structures and negotiating positions with Medicaid managed care plans, potentially affecting network adequacy and reimbursement strategies.

Managed Care · Finance

Read the full article at jdsupra.com

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