CMS Proposes 340B Cuts, Site-Neutral Payment Changes for 2027 Outpatient Rule
CMS released a proposed 2027 outpatient payment rule on July 2, 2026, that would cut billions from 340B drug payments and expand site-neutral payment policies affecting hospital reimbursement. The rule compounds financial pressure on hospitals already facing margin challenges, combining payment reductions that hospital finance leaders have previously fought separately. Comments on the proposed rule are due under the standard federal rulemaking timeline, typically 60 days from publication. The combined effect threatens Medicaid DSH hospitals and safety-net providers that rely heavily on 340B revenue and outpatient volume.
State Medicaid agencies and managed care plans should anticipate hospital network stability concerns and potential provider terminations if safety-net hospitals face simultaneous 340B cuts, site-neutral reimbursement expansion, and state Medicaid rate pressure.
Finance · Pharmacy · Managed Care
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