Today the FAH submitted comments to CMS on key issues in the Outpatient Prospective Payment System and Ambulatory Surgery Center Proposed Rule for CY 2026.  The letter urged CMS to finalize OPPS policies that sustain hospital access to outpatient and emergency services, avoid unlawful recoupments, protect patient safety, and ensure transparent yet workable reporting, including the following key issues:

• OPPS Update and 340B Recoupment: The letter laid out legal arguments strongly opposed to CMS’s $7.8 billion retrospective recoupment and the resulting proposal to cut the OPPS conversion factor by 2 percent beginning in CY 2026 as part of its 340B Remedy recoupment transition. The FAH also urged CMS to adopt a one-time forecast error adjustment to the CY 2026 OPPS update based on the forecast shortfalls in the hospital market basket in FY 2021 through FY 2024 totaling 4.6 percent.
• Site-Neutral Payment Proposals: FAH comments opposed CMS’s proposals to expand site-neutral payment policies to Part B drug administration in grandfathered, off-campus provider-based departments and provided legal arguments that any cuts for drug administration must be done in a budget neutral manner as required by law.
• Elimination of the Inpatient-Only (IPO) List: The FAH urged CMS to retain the IPO list as a vital patient-safety tool, supported by annual, evidence-based review and raised concerns that wholesale elimination would expose beneficiaries to inappropriate outpatient procedures, increase disputes with MA plans, and erode the clarity of Part A and Part C benefits.
• Hospital Price Transparency: The FAH letter recommended that CMS maintain the hospital price transparency rules in their current form and seek ways to reduce hospital burden. 
• Market-Based MS-DRG Proposals: The letter strongly opposed CMS’s proposal to require the reporting of median payer-specific negotiated rate data for MA plans and their use in the FFS inpatient MS-DRG weighting methodology.  The letter highlighted that the proposal severely underestimates the operational burdens and costs of compliance and overestimates the value and utility of median payer-specific negotiated rate data – in addition to lacking legal authority.

Read the full letter here.