AAMC - Association of American Medical Colleges

07/18/2025 | Press release | Distributed by Public on 07/18/2025 15:41

AAMC Issues Statement on Release of CY26 OPPS Proposed Rule

Contacts

Phoebe Ramsey, Director, Physician Payment & Quality
Katherine Gaynor, Hospital Policy and Regulatory Analyst
Brad Cunningham, Sr. Regulatory Analyst, Graduate Medical Education
For Media Inquiries

AAMC President and CEO David J. Skorton, MD, and AAMC Chief Health Care Officer Jonathan B. Jaffery, MD, MS, MMM, FACP, issued a July 17 statement following the release of the Centers for Medicare & Medicaid Services (CMS) calendar year (CY) 2026 Outpatient Prospective Payment System (OPPS) proposed rule. The statement noted the AAMC's deep concern that provisions in the proposed rule would "reduce payments to hospitals and profoundly harm the ability for academic health systems and teaching hospitals to care for the patients and communities they serve."

In the proposed rule, the CMS proposes to increase the payment rates by 2.4% for items and services paid under OPPS for CY 2026. The agency is also proposing to accelerate the reduction in OPPS payment rates for nondrug items and services to offset lump sum payments previously paid to 340B hospitals from 0.5% over 16 years to 2% over six years. Additionally, the CMS is proposing to expand its site-neutral payment policies to excepted off-campus hospital outpatient departments for drug administration services and seeks feedback on expanding such policies to on-campus clinic visits, as well as establishing a systematic process to identify services at risk of shifting to the hospital setting based on financial incentives and adjusting payments accordingly. Other proposals focus on phasing out the inpatient only (IPO) list, modifying hospital price transparency rules and enforcement, updating MS-DRG relative weights in the inpatient setting using median payer-specific charges as negated by hospitals with Medicare Advantage organizations and issuing a notice of intent to survey all hospitals for Medicare OPPS drugs acquisition costs.

Specific to graduate medical education, the agency proposes to modify the definition for approved medical residency programs to include that accreditors may not require as part of accreditation, or otherwise encourage institutions to put in place, diversity, equity, and inclusion programs that encourage unlawful discrimination on the basis of race or other violations of federal law.

The CMS also proposes to modify the Outpatient Quality Reporting Program's measure set by adopting one new measure on Emergency Care Access and Timeliness and removing six measures and seeks feedback on new measures of well-being and nutrition. Regarding the Overall Hospital Quality Star Ratings, the agency proposes to modify the methodology to emphasize patient safety by adopting a phased approach to penalizing hospitals in the bottom quartile of performance in the Safety of Care measure group. Comments are due Sept. 15.

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