Premier Submits Comments on CY 2027 Medicare Outpatient Payment Proposed Rule

Premier submitted comments to CMS on the CY 2027 Hospital Outpatient Prospective Payment System (OPPS) proposed rule. In its letter, Premier cautions that several proposed policies, if finalized, could further exacerbate the financial pressures facing hospitals and health systems. Premier also responded to CMS' request for information on policies intended to strengthen domestic manufacturing and improve the resilience of the healthcare supply chain.

Among other recommendations, Premier urged CMS to:

• Adopt new or supplemental data sources to ensure labor costs, inclusive of contract labor, are adequately reflected in the Medicare hospital payment;
• Not finalize the proposed 3.0 percentage point reduction to the OPPS update to recoup expenditures for 340B acquired drugs as the adjustment is inconsistent with statute and CMS’ past practice with respect to applying budget neutrality;
• Not finalize the proposal to reduce payments for 340B acquired drugs from average sales price (ASP) minus 6 percent to ASP minus 33.4 percent as it is based on questionable data and will be harmful to hospitals;
• Consider policies to incentivize hospitals to purchase domestically-produced personal protective equipment (PPE) and essential medicines that are voluntary, not administratively burdensome, not subject to overall funding limits, and implemented in a non-budget neutral manner;
• Not finalize payment reductions for imaging without contrast as CMS has not demonstrated that growth in these services is unnecessary, and the reduction CMS has proposed is inconsistent with the statutory authority it cites;
• Finalize proposals that would require a one-time initial attestation of provider-based status and a subsequent attestation every five years;
• Rather than removing hundreds of procedures from the inpatient only list, propose criteria that would empower clinicians, using their clinical judgement in certain situations, to override the inpatient only requirement and receive payment for procedures performed in the outpatient setting; and
• Narrowly adopt an ACP measure in select quality reporting programs as it could improve end-of-life quality for patients and potentially avoid costly and unnecessary interventions.