AHA comments on CY 2026 OPPS proposed rule

The AHA commented Sept. 15 on the Centers for Medicare & Medicaid Services calendar year 2026 outpatient prospective payment system and ambulatory surgical center payment system proposed rule. The AHA expressed support for several policies in the rule, including direct supervision requirements for certain cardiac rehabilitation services and removing four measures from the Outpatient Quality Reporting program that were recently finalized for removal from the Inpatient Quality Reporting Program, along with the proposal to offer time extensions for data reporting for facilities experiencing an extraordinary circumstance. Provisions the AHA opposed include reducing payment for all drug administration services furnished in off-campus hospital provider-based departments to the “physician fee schedule-equivalent” rate of 40% of the OPPS payment amount, eliminating the inpatient-only list over three years, weakening the ASC Covered Procedures List standard criteria and general exclusion criteria and accelerating the timeline for clawing back funds from CMS' unlawful policy between CY 2018 and 2022 that harmed certain hospitals participating in the 340B Drug Pricing Program.