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