United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2026_register executive 2026-07-07 article Part II Proposed Rules D09002ee1e4805859 D09002ee1e4805942 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027 based on our continuing experience with these systems. We also describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting Program and the Ambulatory Surgical Center Quality Reporting Program. There are no changes to the Rural Emergency Hospital Quality Reporting Program. We propose to expand the prior authorization requirement to include additional Botulinum Toxin Injection services. We also propose to implement certain provisions of the Consolidated Appropriations Act, 2026, for off-campus outpatient departments of a provider. In addition, this proposed rule announces notices of closure of teaching hospitals and opportunities to apply for available slots. This rule also requests information regarding potential approaches to improve comparability and standardization, particularly for complex contracting methodologies, of the HPT information reported in machine- readable files and consumer-friendly displays. We propose hospital AOs with deeming authority to assess compliance with certain Emergency Medical Treatment and Labor Act (EMTALA) administrative requirements during accreditation and reaccreditation surveys. Finally, we are soliciting comments on a potential separate payment under the Inpatient Prospective Payment System (IPPS) for domestic procurement of personal protective equipment and essential medicines. 91 FR 41734 https://www.govinfo.gov/app/details/FR-2026-07-07/2026-13656 2026-13656 fr07jy26-15 RIN 0938-AV83 4169-69-P CMS-1850-P https://www.govinfo.gov/app/details/FR-2026-07-07/2026-13656 https://www.govinfo.gov/content/pkg/FR-2026-07-07/html/2026-13656.htm https://www.govinfo.gov/content/pkg/FR-2026-07-07/pdf/2026-13656.pdf Diseases Health Facilities Medicare Puerto Rico Reporting and Recordkeeping Requirements Health Professions Hospitals Administrative Practice and Procedure Biologics Inflation Rebates Prescription Drugs 299 p. 41734 42032 91 FR 41734 Title 42 Part 413 42 CFR Part 413 Title 42 Part 416 42 CFR Part 416 Title 42 Part 419 42 CFR Part 419 Title 42 Part 427 42 CFR Part 427 Title 42 Part 488 42 CFR Part 488 RIN 0938-AV83 Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots; Federal Register Vol. 91, Issue PRORULE 2026-13656 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 2026-08-31 CMS-1850-P 4169-69-P 2026-13656 Proposed rule.

This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027 based on our continuing experience with these systems. We also describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting Program and the Ambulatory Surgical Center Quality Reporting Program. There are no changes to the Rural Emergency Hospital Quality Reporting Program. We propose to expand the prior authorization requirement to include additional Botulinum Toxin Injection services. We also propose to implement certain provisions of the Consolidated Appropriations Act, 2026, for off-campus outpatient departments of a provider. In addition, this proposed rule announces notices of closure of teaching hospitals and opportunities to apply for available slots. This rule also requests information regarding potential approaches to improve comparability and standardization, particularly for complex contracting methodologies, of the HPT information reported in machine- readable files and consumer-friendly displays. We propose hospital AOs with deeming authority to assess compliance with certain Emergency Medical Treatment and Labor Act (EMTALA) administrative requirements during accreditation and reaccreditation surveys. Finally, we are soliciting comments on a potential separate payment under the Inpatient Prospective Payment System (IPPS) for domestic procurement of personal protective equipment and essential medicines.

To be assured consideration, comments must be received at one of the addresses provided below, by August 31, 2026. Regulation coordination questions, contact Gina Aughenbaugh via email at OutpatientPPS@cms.hhs.gov. Diseases Health Facilities Medicare Puerto Rico Reporting and Recordkeeping Requirements Health Professions Hospitals Administrative Practice and Procedure Biologics Inflation Rebates Prescription Drugs Medicare Program Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; etc., Abigail.Cesnik@cms.hhs.gov Anita.Bhatia@cms.hhs.gov APCPanel@cms.hhs.gov ASCPPS@cms.hhs.gov CAA_2026_Section_6225@cms.hhs.gov Cory.Duke@cms.hhs.gov DAC@cms.hhs.gov DevicePTapplications@cms.hhs.gov Elise.Barringer@cms.hhs.gov Erick.Chuang@cms.hhs.gov Gil.Ngan@cms.hhs.gov Kimberly.Go@cms.hhs.gov Kristina.Rabarison@cms.hhs.gov Marina.Kushnirova@cms.hhs.gov Marsha.Hertzberg@cms.hhs.gov Melissa.Daly@cms.hhs.gov Melissa.Hager@cms.hhs.gov Nathan.Vercauteren@cms.hhs.gov NewTechAPCapplications@cms.hhs.gov Nicole.Marcos@cms.hhs.gov OutpatientPPS@cms.hhs.gov PHPPaymentPolicy@cms.hhs.gov PriceTransparencyHospitalCharges@cms.hhs.gov Scott.Talaga@cms.hhs.gov 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